Effect of A 7-F Transurethral Catheter on Abdominal Leak Point Pressure Measurement in Men With Post-prostatectomy Incontinence

OBJECTIVES To assess the quantitative effect of the 7-F catheter on resultant abdominal leak point pressure (ALPP). The numerical value of ALPP in men with post-prostatectomy incontinence (PPI) may have some utility in directing therapy for this condition. Yet, no standardized method of calculating this value has been agreed upon. It has been suggested that the presence and size of the transurethral urodynamic catheter may affect ALPP. METHODS A retrospective chart review of 20 consecutive men with symptomatic PPI was conducted. Multichannel video-urodynamics were performed using a 7-F transurethral catheter and a rectal catheter. The presence of sphincteric incontinence was elicited using the Valsalva maneuver and ALPP recorded from both vesical and rectal transducers. The transurethral catheter was then removed and ALPP repeated in the absence of a vesical transducer, permitting rectal transducer measurements only. Statistical analysis was performed using Wilcoxon signed-rank test. RESULTS The mean age of this cohort was 66.4 years (range 54-78). All men showed a decrease in ALPP when performed without the urethral catheter. Mean ALPP with and without the transurethral catheter was 66.1 cm H2O (95% CI, 50.4-81.8 cm H2O) and 35.7 cm H2O (95% CI, 20.0-51.4 cm H2O), respectively (P <.01). A strong correlation between mean ALPP with and without the transurethral catheter was noted (r = .83). CONCLUSIONS A 7-F transurethral catheter can affect absolute ALPP measurements in men with PPI. In this study, removal of the transurethral catheter resulted in a significant linear decline in ALPP. This finding may have clinical importance in centers where ALPP is used as a factor in determining therapy for PPI. ALPP standardization is needed. UROLOGY 77: 1188-1193, 2011. (C) 2011 Elsevier Inc.