Stress leak point pressure: A simple and reproducible method utilizing a fiberoptic microtransducer

Objectives: This work demonstrates a simple technique utilizing a fiberoptic microtransducer that provides statistically reproducible stress leak point pressure (SLPP) results without the use of fluorourodynamics. Methods: Nineteen stress incontinent patients with varied clinical histories underwent two SLPP measurements on 2 separate days, totaling four data points. A 14 F catheter sheath was inserted to empty the bladder. Through this sheath, a 5 F fiberoptic microtransducer was inserted into the bladder and zeroed. Then, 250 cc of indigo-carmirte solution was instilled, during which a filling cystometrogram was performed. The sheath was removed, leaving only the 5 F transducer in the bladder. A 2 by 2 inch gauze was placed at the meatus. As each participant performed a slow Valsalva maneuver, an event marker was used to note the pressure at which indigo solution was first seen to stain the gauze. Results: SLPPs ranged from 15 to 140 cm water (H₂O). A two-tailed paired t test demonstrated no statistical difference (P < 0.6) between the two SLPPs performed on day 1, with a mean difference of 1.05 .61 (95% confidence interval [Cl]). Comparison of the two SLPPs performed on day 2 also revealed no statistical difference (P < 0.8), with a mean difference of -0.17 .65 (95% Cl). Lastly, comparison of the mean SLPPs from day 1 with the mean SLPPs from day 2 revealed no statistically significant difference (P < 0.8), with the mean difference of -0.59 .62 (95% Cl). Conclusions: This study demonstrates a simple technique that produces reproducible SLPP measurements in a wide variety of clinical settings and avoids ionizing radiation.