STRESS LEAK POINT PRESSURE - A SIMPLE AND REPRODUCIBLE METHOD UTILIZING A FIBEROPTIC MICROTRANSDUCER

Objectives. This work demonstrates a simple technique utilizing a fibe roptic microtransducer that provides statistically reproducible stress leak point pressure (SLPP) results without the use of fluorourodynami cs. Methods. Nineteen stress incontinent patients with varied clinical histories underwent two SLPP measurements on 2 separate days, totalin g four data points. A 14 F catheter sheath was inserted to empty the b ladder. Through this sheath, a 5 F fiberoptic microtransducer was inse rted into the bladder and zeroed. Then, 250 cc of indigo-carmine solut ion was instilled, during which a filling cystometrogram was performed . The sheath was removed, leaving only the 5 F transducer in the bladd er. A 2 by 2 inch gauze was placed at the meatus. As each participant performed a slow Valsalva maneuver, an event marker was used to note t he pressure at which indigo solution was first seen to stain the gauze . Results. SLPPs ranged from 15 to 140 cm water (H2O). A two-tailed pa ired t test demonstrated no statistical difference (P < 0.6) between t he two SLPPs performed on day 1, with a mean difference of 1.05 +/- 2. 61 (95% confidence interval [Cl]). Comparison of the two SLPPs perform ed on day 2 also revealed no statistical difference (P < 0.8), with a mean difference of -0.17 +/- 5.65 (95% CI). Lastly, comparison of the mean SLPPs from day 1 with the mean SLPPs from day 2 revealed no stati stically significant difference (P < 0.8), with the mean difference of -0.59 +/- 1.62 (95% CI). Conclusions. This study demonstrates a simpl e technique that produces reproducible SLPP measurements in a wide var iety of clinical settings and avoids ionizing radiation.