Valsalva Leak Point Pressure Measurement in Women with Stress Urinary Incontinence: At what Bladder Volume?

Abstract

Valsalva leak point pressure (VLPP) is a dynamic test that measures the bladder neck or proximal urethra response to abdominal pressure during the evaluation of stress urinary incontinence (SUI) in women by a urodynamic study (UDS). It is an important urodynamic tool for the assessment of disease severity, choice of therapy and objective post therapeutic follow- up. However, many factors including the bladder volume affect VLPP and therefore a standardization of these factors is still necessary. A number of studies suggest that as the bladder volume increases VLPP decreases, implying that higher bladder volumes open the urethra sphincters henceforth VLPP demonstrated at these bladder volumes might reflect the distal urethra function instead of the proximal urethra function. We hereby highlight the effects of bladder volume on VLPP in women with SUI and recommend the bladder volume at which VLPP should be demonstrated out during the urodynamic assessment of urethra function after reviewing a number of available clinical studies.