What does this research mean for the field?

A Valsalva Leak Point Pressure (VLPP) of less than 90 cmH2O is associated with higher rates of postoperative urinary incontinence following transobturator tape surgery for stress urinary incontinence. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study investigates how Valsalva Leak Point Pressure (VLPP) and urge incontinence affect surgical outcomes for stress urinary incontinence (SUI).

March 3, 2026Open Access

Evaluating the Impact of Valsalva Leak Point Pressure and Urge Incontinence on the Success of Transobturator Tape Surgery for Stress Urinary Incontinence

Key Points

The study investigates how Valsalva Leak Point Pressure (VLPP) and urge incontinence affect surgical outcomes for stress urinary incontinence (SUI).
Conducted a retrospective study of 117 patients who underwent transobturator tape surgery for SUI.
Performed urodynamic testing, including VLPP measurement, prior to surgery.
Evaluated postoperative outcomes using stress tests and the ICIQ-SF questionnaire.
14.5% of patients experienced surgical failure while 85.5% reported success postoperatively.
Lower VLPP values were correlated with higher rates of postoperative urinary incontinence (p = 0.001).
Postoperative scores on the ICIQ-SF showed significant improvement (p < 0.001).

Abstract

Objective: This study aimed to investigate factors influencing the surgical outcomes of patients undergoing transobturator tape (TOT) surgery for stress urinary incontinence (SUI), focusing on the predictive value of Valsalva Leak Point Pressure (VLPP) and the presence of urge incontinence. Material and Methods: A retrospective study was conducted involving 117 patients from 561 who underwent TOT surgery between May 2017 and March 2024. We excluded patients with prior pelvic surgeries or neurogenic bladder, and included SUI with urethral hypermobility as an inclusion criterion. We performed urodynamic testing, including VLPP measurement, preoperatively. Postoperative outcomes were evaluated using stress tests, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), and assessments of urge incontinence and cystocele presence. Results: Postoperative stress tests revealed 14.5% failure and 85.5% success rates. We observed significant differences in urinary incontinence (UI) amount based on VLPP values (p = 0.001), where lower VLPP was associated with higher postoperative UI rates. Urge incontinence had a significant impact on postoperative UI (p = 0.023), but it did not correlate with preoperative UI frequency. Postoperatively, ICIQ-SF scores and impact on daily life showed significant improvement (p <0.001). ROC analysis indicated that the impact on daily life was a significant predictor of surgical success (p = 0.035). Conclusion: TOT surgery may significantly improve urinary incontinence symptoms and have a positive impact on daily life. However, a VLPP of less than 90 cmH2O is associated with higher rates of postoperative UI, suggesting a potential intrinsic sphincter deficiency (ISD). Post-surgical urge incontinence presents a significant challenge for individuals, likely due to detrusor muscle overactivity following the surgery. We need further research to refine predictive measures and improve surgical techniques. Keywords: stress urinary incontinence, transobturator tape, urge incontinence, valsalva leak point pressure

Read Full Paperexternally

Bookmark

View Full Paper

Cite This Study

Yentür et al. (Fri,) studied this question.

synapsesocial.com/papers/69a67dd6f353c071a6f09c94 https://doi.org/https://doi.org/10.33719/nju1702466

Bookmark

View Full Paper