Valsalva leak point pressure predicts outcome after transobturator suburethral tape implantation--fact or fiction?

The aim of the study was to assess the influence of Valsalva leak point pressure (VLPP) on outcome of transobturator suburethral tape (TOT) implantation.65 female patients underwent surgery between March 2004 and November 2005. Their inclusion criterion was urodynamic stress urinary incontinence (SUI). The exclusion criteria were detrusor overactivity, detrusor underactivity, a significant post-void residuum and genital prolapse. "Subjective improvement" was considered as the difference between postoperative urinary-incontinence specific quality of life compered with its preoperative value (deltaIQoL=IQoL*-IQoL).Postoperative leakage and postoperative urinary incontinence specific quality of life in 1st versus 2nd group were 1.2+/-1.1 g and 90.6+/-5.1 versus 4.6+/-3.1 g and 84.0=5.6 respectively (p<0.005 and p<0.005 respectively).Cure and success rates were significantly higher in patients with higher VLPP values compared with patients with lower VLPP values. In spite of the fact that patients with higher VLPP values achieved significantly lower postoperative leakage, urine leakage decreased significantly more in patients with lower VLPP values. Patients with higher VLPP values reached significantly higher postoperative urinary incontinence-specific quality of life, however no significant difference was found in subjective improvement between patients with higher and lower VLPP values (Tab. 1, Ref. 23).