Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Urology. 2011 May;77(5):1188-93. doi: 10.1016/j.urology.2010.07.478. Epub 2011 Jan 21.
To assess the quantitative effect of the 7-F catheter on resultant abdominal leak point pressure (ALPP). The numerical value of ALPP in men with post-prostatectomy incontinence (PPI) may have some utility in directing therapy for this condition. Yet, no standardized method of calculating this value has been agreed upon. It has been suggested that the presence and size of the transurethral urodynamic catheter may affect ALPP.
A retrospective chart review of 20 consecutive men with symptomatic PPI was conducted. Multichannel video-urodynamics were performed using a 7-F transurethral catheter and a rectal catheter. The presence of sphincteric incontinence was elicited using the Valsalva maneuver and ALPP recorded from both vesical and rectal transducers. The transurethral catheter was then removed and ALPP repeated in the absence of a vesical transducer, permitting rectal transducer measurements only. Statistical analysis was performed using Wilcoxon signed-rank test.
The mean age of this cohort was 66.4 years (range 54-78). All men showed a decrease in ALPP when performed without the urethral catheter. Mean ALPP with and without the transurethral catheter was 66.1 cm H(2)O (95% CI, 50.4-81.8 cm H(2)O) and 35.7 cm H(2)O (95% CI, 20.0-51.4 cm H(2)O), respectively (P <.01). A strong correlation between mean ALPP with and without the transurethral catheter was noted (r = .83).
A 7-F transurethral catheter can affect absolute ALPP measurements in men with PPI. In this study, removal of the transurethral catheter resulted in a significant linear decline in ALPP. This finding may have clinical importance in centers where ALPP is used as a factor in determining therapy for PPI. ALPP standardization is needed.
评估 7-F 导管对腹压漏点压（ALPP）的定量影响。患有前列腺切除术后尿失禁（PPI）的男性的 ALPP 数值可能在指导该疾病的治疗方面具有一定的作用。然而，目前还没有达成共识的计算此数值的标准化方法。有人认为，经尿道尿动力学导管的存在和大小可能会影响 ALPP。
对 20 例连续的有症状 PPI 男性进行了回顾性图表分析。使用 7-F 经尿道导管和直肠导管进行多通道视频尿动力学检查。通过瓦尔萨尔手法引出括约肌失禁，并从膀胱和直肠换能器记录 ALPP。然后移除经尿道导管，在没有膀胱换能器的情况下重复 ALPP，仅允许直肠换能器进行测量。使用 Wilcoxon 符号秩检验进行统计分析。
该队列的平均年龄为 66.4 岁（范围 54-78 岁）。所有男性在不使用尿道导管时 ALPP 均降低。有和无经尿道导管时的平均 ALPP 分别为 66.1cmH2O（95%CI，50.4-81.8cmH2O）和 35.7cmH2O（95%CI，20.0-51.4cmH2O）（P<.01）。有和无经尿道导管时的平均 ALPP 之间存在很强的相关性（r=.83）。
7-F 经尿道导管会影响患有 PPI 的男性的绝对 ALPP 测量值。在这项研究中，移除经尿道导管导致 ALPP 显著线性下降。这一发现可能对 ALPP 用于确定 PPI 治疗的中心具有临床意义。需要对 ALPP 进行标准化。
