Abstract

GUTIERREZ BANOS, J.L. et al. Usefulness of abdominal leak point pressure determination in the diagnosis of female urinary incontinence in the TVT era. Actas Urol Esp [online]. 2004, vol.28, n.7, pp.506-512. ISSN 0210-4806.

OBJECTIVE: To analyse our results about continence in the treatment of female urinary incontinence with the tension- free vaginal tape (TVT) procedure based on abdominal leak point pressure (ALPP). PATIENTS AND METHODS: Retrospective study of the fifty two patients who had urodynamic study and abdominal leak point pressure determination and were operated on between 1999 and 2002 for stress urinary incontinence. We reviewed the data of clinical history, physical examination and urodynamic report, surgery, complications, and objective and subjective results. Those patients having ALPP>100 are included in group 1, between 61 and 100 in group 2 and less than 60 in group 3. RESULTS: There were 19 patients in group 1, 17 in group 2 and 16 in group 3. We found no difference between the three groups regarding age, delivery, menopause, hysterectomy, evolution, previous surgery, grade of cystocele, association of anterior colporraphy to TVT and type of anaesthesia. The Obrink clinical grade increased as the ALPP decreased (grade 3 in 26.32% of group 1, 31.58% in group 2 and 68.71% in group 3). 100% of patients in groups 1 and 2 were continent with effort and 93.75% in group 3. Complications, especially de novo instability or urgency-frequency episodes or persistence of instability in patients having mixed incontinence, caused a decrease in the satisfaction degree to 79% in group 1, 76.5% in 2 and 62.5% in 3. CONCLUSIONS: Abdominal leak point pressure determination does not change our decision of perform a TVT procedure but permits us to differentiate one group in which results could be worse.

Keywords : Stress urinary incontinence; TVT; Abdominal leak point pressure; Uretropexy.

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