ABSTRACT
The concept of leak point pressure (LPP) determination was introduced by McGuire et al. (1).
The first LPP to be defined was the detrusor or bladder leak point pressure (DLPP) and was
correlated with an increased risk of upper tract deterioration in children with meningomyelocele
(1). The definition of abdominal LPP (ALPP) was to follow (2), and it was used to categorize
patients into either anatomical or intrinsic sphincteric deficiency (ISD), the two types of stress
urinary incontinence. ALPPs can be further divided to ALPP measured during Valsalva
maneuver (VLPP) and ALPP measured during cough (CLPP). There is lack of standardization of
how LPPs are measured. Different entities of LPP and a great variation in the techniques used to
measure each of these entities have led to considerable confusion among professionals. The
clinical applicability of these tests is therefore still controversial, and interpretation of results is
difficult. The definitions of LPP, the techniques used for their measurement, and their clinical
applicability are described and discussed.
