Retrograde leak point pressures in incontinent men Version 1
Research type
Research Study
Full title
The use of retrograde leak-point pressure measurement in the assessment of incontinent men with artificial urinary sphincters, and its correlation with ultrasound imaging of the pressure-regulating balloon
IRAS ID
117768
Contact name
Alex Kirkham
Contact email
Sponsor organisation
University College London
Research summary
Urinary incontinence in men may be due to a variety of different causes, one of the commonest being the result of radical surgery for prostate cancer (PPI). Despite recent advances in surgical technique, PPI remains a disabling complication, with the majority of cases resulting from weakness of the urethral sphincter (intrinsic sphincter deficiency) following surgery. Urodynamic testing prior to definitive treatment is currently routinely performed to confirm the diagnosis and identify factors that may affect the success of surgical treatment. This standard procedure involves the use of x-rays. The best method to evaluate the degree of weakness of the sphincter muscle is debatable. The retrograde leak point pressure (RLPP) is one such measure that has been shown to be accurate, objective and reliable in assessing the degree of sphincter weakness. However, it has not been studied extensively in men with PPI, or in men who have been treated for PPI with an artificial urinary sphincter.
We aim to determine whether RLPP measurements in men with PPI correlate with objective measures of incontinence severity (using 24-hour pad weights and symptom scores), whether this improves following surgery, and if the results influence the clinical outcome.
Secondly, we aim to determine the utility of RLPP in the investigation of men who are incontinent despite AUS implantation, comparing this to the RLPP of men who are continent following AUS insertion.
Thirdly, we aim to determine the accuracy of ultrasound imaging of the pressure regulating balloon of the AUS in determining the fluid status of the AUS, correlating this with function as measured by the RLPP, 24-hour pad weights, and symptoms scores. The point of this is to see whether we can the current standard practice of using ionising radiation (x-rays) to investigate men who have recurrent incontinence after AUS insertion.
REC name
London - Harrow Research Ethics Committee
REC reference
13/LO/0747
Date of REC Opinion
17 Jul 2013
REC opinion
Further Information Favourable Opinion