Twiss Christian O, Fischer Melissa C, Nitti Victor W
Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
Neurourol Urodyn. 2007;26(1):8-13. doi: 10.1002/nau.20333.
We assessed the utility of three self-assessment instruments: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the post-operative Patient Global Impression of Improvement (PGI-I) score, and the International Prostate Symptom Score (IPSS) by correlating them with an objective outcome, the change in 24-hr pad weight, after a male perineal sling.
Twenty-six men with urodynamically confirmed stress incontinence underwent a male perineal sling. Patients were evaluated pre-operatively and post-operatively with a 24-hr pad test, IPSS and ICIQ-SF. Patients also completed the PGI-I post-operatively. Changes in study parameters were compared via the paired t-test, and correlations were performed using Spearman's rho.
There were significant reductions in 24-hr pad weight (-274 g, P < 0.001), percentage 24-hr pad weight (54.2%), ICIQ-SF score (-6.3, P < 0.001), and the three ICIQ-SF subscores (-1.2, -1.7, -3.4 for Questions 3, 4, and 5, respectively, P < 0.001 for all). The change in total ICIQ-SF score and the post-operative PGI-I score correlated strongly with percentage reduction in 24-hr pad weight (r = -0.68, P < 0.001; r = -0.81, P < 0.001, respectively) and with each other (r = 0.79, P < 0.001). The change in all three ICIQ-SF subscores correlated significantly with percentage reduction in 24-hr pad weight and with post-operative PGI-I score. There was no significant change in the IPSS or the voiding or storage subscores, and none correlated with any other study parameter.
This study validates the construct validity of the ICIQ-SF and PGI-I in the assessment of treatment for male stress incontinence and should make clinicians confident in comparing studies of incontinence treatment utilizing the change ICIQ-SF score, the post-operative PGI-I score, and percentage reduction in 24-hr pad weight as outcome measures.
我们评估了三种自我评估工具的效用：国际尿失禁咨询问卷简表（ICIQ-SF）、术后患者总体改善印象（PGI-I）评分以及国际前列腺症状评分（IPSS），通过将它们与男性会阴吊带术后的客观结果24小时尿垫重量变化进行关联分析。
26名经尿动力学证实为压力性尿失禁的男性接受了男性会阴吊带手术。术前和术后对患者进行24小时尿垫试验、IPSS和ICIQ-SF评估。患者术后还完成了PGI-I评估。通过配对t检验比较研究参数的变化，并使用Spearman等级相关系数进行相关性分析。
24小时尿垫重量显著减少（-274克，P<0.001），24小时尿垫重量百分比减少（54.2%），ICIQ-SF评分降低（-6.3，P<0.001），以及ICIQ-SF的三个子评分分别降低（问题3、4和5分别为-1.2、-1.7和-3.4，均P<0.001）。ICIQ-SF总分的变化和术后PGI-I评分与24小时尿垫重量减少百分比密切相关（r=-0.68，P<0.001；r=-0.81，P<0.001），且彼此相关（r=0.79，P<0.001）。ICIQ-SF的所有三个子评分变化与24小时尿垫重量减少百分比以及术后PGI-I评分均显著相关。IPSS或排尿或储尿子评分无显著变化，且与任何其他研究参数均无相关性。
本研究验证了ICIQ-SF和PGI-I在评估男性压力性尿失禁治疗中的结构效度，应使临床医生有信心比较利用ICIQ-SF评分变化、术后PGI-I评分以及24小时尿垫重量减少百分比作为结局指标的尿失禁治疗研究。
