Leakpoint pressures in female stress urinary incontinence.

Patient selection is critical to achieving good results in the surgical management of stress urinary incontinence. The evaluation of urethral function in these women is of great importance, since the choice of operative technique often depends on the ability of the urethra to generate adequate resistance to the expulsive forces of increased abdominal pressure. The Valsalva leakpoint pressure (VLPP) has been described as an easily performed, reproducible and accurate urodynamic test to assess the patient for the presence of intrinsic sphincter deficiency (ISD). Critical review of the VLPP demonstrates its reproducibility and correlation with other measures of ISD. However, more work needs to be done to identify the truly critical values of VLPP that would help in selecting the most appropriate procedure in surgery for stress incontinence.