Bump R C, Elser D M, Theofrastous J P, McClish D K
Department of Obstetrics and Gynecology, Medical College of Virginia/Virginia Commonwealth University, Richmond, Virginia, USA.
Am J Obstet Gynecol. 1995 Aug;173(2):551-7. doi: 10.1016/0002-9378(95)90281-3.
The Valsalva leak point pressure has been promoted as an alternative to urethral pressure profilometry as a measure of urethral resistance in women with genuine stress incontinence. Our aims were to evaluate the reproducibility of the Valsalva leak point pressure, to assess the effect of catheter caliber on the Valsalva leak point pressure, and to compare vesical Valsalva leak point pressure to other measures of urethral resistance.
Sixty consecutive women with genuine stress incontinence underwent duplicate Valsalva leak point pressure determinations by use of 8F and 3F vesical and 8F vaginal catheters. Subjects also underwent a standard resting urethral pressure profilometry, cough leak point pressure determinations, and pressure-flow micturition studies.
Leakage was demonstrated on both Valsalva maneuvers in approximately 80% of subjects with both catheters. In subjects who leaked with both strains there was an extremely high correlation between the test-retest Valsalva leak point pressure within both catheters. The intercatheter correlation between the 8F and 3F Valsalva leak point pressures was significant but much weaker than the intracatheter correlations; 8F Valsalva leak point pressures were significantly higher than 3F Valsalva leak point pressures, although there were individual exceptions to this observation. Urethral pressure profilometry measures and micturition opening pressures were poorly correlated with Valsalva leak point pressure. Cough and vaginal Valsalva leak point pressures were significantly correlated with vesical Valsalva leak point pressure, but cough leak point pressures were significantly higher and vaginal Valsalva leak point pressures were significantly lower than the vesical Valsalva leak point pressure.
Valsalva leak point pressure is a simple and reproducible technique for evaluating urethral resistance in women with genuine stress incontinence. However, variations in Valsalva leak point pressure measurement must be precisely described, standardized, and validated before a technique can be advocated for clinical use.
瓦尔萨尔瓦漏点压已被推荐作为尿道压力测定法的替代方法，用于评估真性压力性尿失禁女性的尿道阻力。我们的目的是评估瓦尔萨尔瓦漏点压的可重复性，评估导管管径对瓦尔萨尔瓦漏点压的影响，并将膀胱瓦尔萨尔瓦漏点压与其他尿道阻力测量方法进行比较。
连续60例真性压力性尿失禁女性使用8F和3F膀胱导管及8F阴道导管进行了两次瓦尔萨尔瓦漏点压测定。受试者还接受了标准静息尿道压力测定、咳嗽漏点压测定和压力-流率排尿研究。
使用两种导管时，约80%的受试者在两次瓦尔萨尔瓦动作时均出现漏尿。在两次动作均漏尿的受试者中，两种导管的复测瓦尔萨尔瓦漏点压之间存在极高的相关性。8F和3F瓦尔萨尔瓦漏点压之间的导管间相关性显著，但远弱于导管内相关性；8F瓦尔萨尔瓦漏点压显著高于3F瓦尔萨尔瓦漏点压，尽管有个别例外情况。尿道压力测定法测量值和排尿起始压力与瓦尔萨尔瓦漏点压的相关性较差。咳嗽和阴道瓦尔萨尔瓦漏点压与膀胱瓦尔萨尔瓦漏点压显著相关，但咳嗽漏点压显著高于膀胱瓦尔萨尔瓦漏点压，而阴道瓦尔萨尔瓦漏点压显著低于膀胱瓦尔萨尔瓦漏点压。
瓦尔萨尔瓦漏点压是评估真性压力性尿失禁女性尿道阻力的一种简单且可重复的技术。然而，在推荐该技术用于临床之前，必须精确描述、标准化并验证瓦尔萨尔瓦漏点压测量中的变异性。
