{"id":12868,"date":"2025-08-14T10:19:42","date_gmt":"2025-08-14T14:19:42","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/vesical-leak-point-pressure-vlpp\/"},"modified":"2026-10-06T18:19:32","modified_gmt":"2026-10-06T22:19:32","slug":"pressao-de-perda-no-ponto-vesical-vlpp","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/pressao-de-perda-no-ponto-vesical-vlpp\/","title":{"rendered":"Press\u00e3o de Perda no Ponto Vesical (VLPP)"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[109],"glossary-product":[],"class_list":["post-12868","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-diagnostic-phenomena"],"acf":{"gt-definition":"<p>A Press\u00e3o de Perda no Ponto Vesical (VLPP), mais comumente chamada de press\u00e3o de perda sob manobra de Valsalva, \u00e9 um teste urodin\u00e2mico din\u00e2mico que mede a menor press\u00e3o intravesical na qual ocorre perda de urina durante o aumento da press\u00e3o abdominal, na aus\u00eancia de contra\u00e7\u00e3o do detrusor.<sup>1<\/sup> Avalia especificamente o limiar de press\u00e3o no qual o mecanismo esfincteriano uretral deixa de manter a contin\u00eancia quando submetido ao aumento da press\u00e3o intra-abdominal por meio de uma manobra de Valsalva.<sup>2<\/sup> A VLPP \u00e9 um par\u00e2metro fundamental para avaliar a integridade do esf\u00edncter uretral e quantificar a gravidade da incontin\u00eancia urin\u00e1ria de esfor\u00e7o.<sup>3<\/sup> O teste \u00e9 realizado durante estudos urodin\u00e2micos, solicitando-se ao paciente que realize uma manobra de Valsalva controlada (expira\u00e7\u00e3o for\u00e7ada contra boca, glote e nariz fechados) enquanto a press\u00e3o vesical \u00e9 medida simultaneamente, sendo a menor press\u00e3o que causa perda vis\u00edvel de urina registrada como o valor de VLPP.<sup>4<\/sup><\/p>","gt-synonyms":"Press\u00e3o do ponto de vazamento de Valsalva, press\u00e3o do ponto de vazamento abdominal (ALPP), Valsalva LPP, teste de press\u00e3o do ponto de vazamento vesical, press\u00e3o do ponto de vazamento da bexiga","gt-citation":"[1] Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5-26. DOI: https:\/\/doi.org\/10.1007\/s00192-009-0976-9\n\n[2] McGuire EJ, Woodside JR, Borden TA, et al. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol. 1981;126(2):205-209. DOI: https:\/\/doi.org\/10.1016\/s0022-5347(17)54449-3\n\n[3] Seo YH, Kim SO, Yu HS, Kwon DD. Leak point pressure at different bladder volumes in stress urinary incontinence in women: Comparison between Valsalva and cough-induced leak point pressure. Can Urol Assoc J. 2016;10(1-2):E23-E27. DOI: https:\/\/doi.org\/10.5489\/cuaj.3329\n\n[4] Yao M, Simoes A. Urodynamic Testing and Interpretation. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 32965981. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562310\/","gt-clinical-context":"<p>A Press\u00e3o de Perda no Ponto Vesical (VLPP) \u00e9 utilizada principalmente na avalia\u00e7\u00e3o cl\u00ednica de pacientes com incontin\u00eancia urin\u00e1ria de esfor\u00e7o (IUE), para avaliar a integridade funcional do mecanismo esfincteriano uretral.<sup>1<\/sup> Esse par\u00e2metro diagn\u00f3stico \u00e9 particularmente valioso para determinar a presen\u00e7a e a gravidade da defici\u00eancia esfincteriana intr\u00ednseca (DEI), uma condi\u00e7\u00e3o caracterizada por coapta\u00e7\u00e3o uretral inadequada que resulta em incontin\u00eancia.<sup>2<\/sup><\/p>\n    \n    <p>A medi\u00e7\u00e3o \u00e9 normalmente realizada durante estudos urodin\u00e2micos completos, com o paciente em posi\u00e7\u00e3o de litotomia sobre uma mesa de urodin\u00e2mica.<sup>3<\/sup> Um equipamento urodin\u00e2mico multicanal registra as press\u00f5es intravesical e abdominal enquanto o paciente realiza uma manobra de Valsalva controlada em volumes vesicais espec\u00edficos, geralmente entre 150-300 mL.<sup>3<\/sup><\/p>\n    \n    <p>O sistema de classifica\u00e7\u00e3o de McGuire fornece orienta\u00e7\u00f5es para a interpreta\u00e7\u00e3o cl\u00ednica: valores de VLPP abaixo de 60 cmH\u2082O sugerem fortemente defici\u00eancia esfincteriana intr\u00ednseca, valores entre 60-90 cmH\u2082O s\u00e3o considerados duvidosos e valores acima de 90 cmH\u2082O geralmente indicam compet\u00eancia esfincteriana.<sup>2<\/sup> Uma press\u00e3o de perda abdominal superior a 150 cmH\u2082O sugere que \u00e9 improv\u00e1vel que a incontin\u00eancia seja causada por incompet\u00eancia uretral.<sup>1<\/sup><\/p>\n    \n    <p>As medi\u00e7\u00f5es de VLPP influenciam significativamente o planejamento do tratamento da incontin\u00eancia urin\u00e1ria de esfor\u00e7o, sobretudo na tomada de decis\u00e3o cir\u00fargica.<sup>4<\/sup> Pacientes com valores baixos de VLPP (&lt;60 cmH\u2082O) podem ter resultados cir\u00fargicos diferentes em compara\u00e7\u00e3o com aqueles com valores mais altos, embora o valor preditivo continue controverso.<sup>1<\/sup> Alguns estudos indicam que uma VLPP pr\u00e9-operat\u00f3ria baixa se correlaciona com maiores taxas de falha ap\u00f3s procedimentos de sling de uretra m\u00e9dia, enquanto outros n\u00e3o mostram rela\u00e7\u00e3o significativa entre a VLPP pr\u00e9-operat\u00f3ria e as taxas de cura p\u00f3s-operat\u00f3rias.<sup>1<\/sup><\/p>\n    \n    <p>\u00c9 importante observar que as medi\u00e7\u00f5es de VLPP podem ser afetadas por v\u00e1rios fatores, incluindo o volume vesical (os valores normalmente diminuem com o aumento do volume), o calibre do cateter, a posi\u00e7\u00e3o do paciente e a presen\u00e7a de prolapso de \u00f3rg\u00e3os p\u00e9lvicos.<sup>3<\/sup> Para uma avalia\u00e7\u00e3o abrangente, a VLPP \u00e9 frequentemente comparada com a press\u00e3o de perda induzida pela tosse (CLPP), que normalmente apresenta valores mais altos no mesmo paciente.<sup>3<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":206},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Press\u00e3o de Perda Vesical (VLPP): Avalia\u00e7\u00e3o da Incontin\u00eancia | Rigicon<\/title>\n<meta name=\"description\" content=\"Conhe\u00e7a a VLPP, teste urodin\u00e2mico que mede a press\u00e3o vesical necess\u00e1ria para causar perda urin\u00e1ria. 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