Comiter C V, Sullivan M P, Yalla S V
Division of Urology, West Roxbury V.A. Medical Center, Massachusetts, USA.
Urology. 1997 Feb;49(2):231-6. doi: 10.1016/S0090-4295(96)00427-X.
To evaluate a technique of measuring the retrograde leak point pressure (RLPP) for assessing men with postradical prostatectomy stress urinary incontinence (SUI).
We measured RLPP in adult men by retrograde infusion of the distal urethra while simultaneously recording intraurethral pressure. The reproducibility of this test, and its dependence on urethral infusion rate, bladder volume, and anterior urethral catheter position, were evaluated. RLPP and abdominal leak point pressure (ALPP) measurements were performed in postradical prostatectomy patients. RLPP was compared with ALPP and with severity of incontinence determined by pad usage.
Repeated RLPP measurements were not significantly different and did not change with bladder volume up to half capacity or with the location of the catheter in the anterior urethra. The differences between RLPP measurements with infusion rates of 2, 4, and 8 mL/min were also not significant. Twenty-seven men were evaluated 6 to 108 months after surgery. Of these, 22 (81%) demonstrated SUI. Mean RLPP in men without SUI (79.2 +/- 14 cm H2O) was significantly higher than in men with SUI (51.9 +/- 13 cm H2O, P < 0.01). In men with SUI, ALPP and RLPP were significantly correlated, and ALPP (49.8 +/- 24 cm H2O) was not significantly different from RLPP (51.9 +/- 13 cm H2O) Pad use and RLPP were also significantly related.
RLPP measurements are reproducible and simple to perform. The pressure at which leakage occurs is easily identifiable as the plateau pressure. RLPP correlates significantly with the lowest of multiple ALPP measurements in men with SUI. This technique represents a reliable urodynamic alternative for evaluating men with postradical prostatectomy SUI.
评估一种测量逆行漏点压力（RLPP）的技术，用于评估根治性前列腺切除术后压力性尿失禁（SUI）的男性患者。
我们通过向成年男性远端尿道逆行灌注，同时记录尿道内压力来测量RLPP。评估该测试的可重复性及其对尿道灌注速率、膀胱容量和前尿道导管位置的依赖性。对根治性前列腺切除术后患者进行RLPP和腹压漏点压力（ALPP）测量。将RLPP与ALPP以及根据尿垫使用情况确定的尿失禁严重程度进行比较。
重复测量RLPP无显著差异，在膀胱容量达到半容量之前或导管在前尿道的位置改变时，RLPP也无变化。灌注速率为2、4和8 mL/min时测量的RLPP之间的差异也不显著。对27名男性患者在术后6至108个月进行了评估。其中，22名（81%）表现为SUI。无SUI男性的平均RLPP（79.2±14 cm H₂O）显著高于有SUI的男性（51.9±13 cm H₂O，P<0.01）。在有SUI的男性中，ALPP和RLPP显著相关，且ALPP（49.8±24 cm H₂O）与RLPP（51.9±13 cm H₂O）无显著差异。尿垫使用情况与RLPP也显著相关。
RLPP测量具有可重复性且操作简单。漏尿发生时的压力很容易识别为平台压。在有SUI的男性中，RLPP与多次ALPP测量中的最低值显著相关。该技术是评估根治性前列腺切除术后SUI男性患者的一种可靠的尿动力学方法。
