Albo Michael, Wruck Lisa, Baker Jan, Brubaker Linda, Chai Toby, Dandreo Kimberly J, Diokno Ananias, Goode Patricia, Kraus Stephen, Kusek John W, Lemack Gary, Lowder Jerry, Steers William
Division of Urology, University of California, San Diego, California 92103-8897, USA.
J Urol. 2007 May;177(5):1810-4. doi: 10.1016/j.juro.2007.01.032.
We assessed the relationships among severity measures of urinary incontinence in women with stress predominant symptoms enrolled in a randomized clinical trial comparing 2 surgical techniques (Burch colposuspension vs pubovaginal sling) for stress urinary incontinence.
A total of 655 women underwent a standardized preoperative assessment that included the Medical, Epidemiological and Social Aspects of Aging questionnaire, Urogenital Distress Inventory, Incontinence Impact Questionnaire, 3-day voiding diary, 24-hour pad test, a supine empty bladder stress test and Valsalva leak point pressure measurements. Correlations were estimated using Spearman correlation coefficients and 95% confidence intervals. T tests at alpha=0.05 were conducted to compare the distributions of the continuous severity measure between patients with positive and negative supine empty bladder stress test.
Baseline mean scores on Medical, Epidemiological and Social Aspects of Aging, Urogenital Distress Inventory and Incontinence Impact Questionnaire were 25.8, 151 and 171, respectively. Mean incontinence episode frequency and pad weight were 3.2 per day and 43.5 gm, respectively. Supine empty bladder stress test was positive in 218 patients, and 428 patients had valid Valsalva leak point pressure measurements with a mean Valsalva leak point pressure of 80 cm H(2)O. Weak to moderate correlations were observed between Medical, Epidemiological and Social Aspects of Aging, incontinence episode frequency, pad weight, Incontinence Impact Questionnaire and Urogenital Distress Inventory. On the other hand, Valsalva leak point pressure correlated poorly with all variables measured. The sensitivity and specificity of the supine empty bladder stress test to predict intrinsic sphincter dysfunction were 49% and 60%, respectively.
Urinary incontinence severity measures correlate moderately with each other at best. While Medical, Epidemiological and Social Aspects of Aging demonstrated stronger correlations with the other measures of severity and quality of life, Valsalva leak point pressure did not. Supine empty bladder stress test did not demonstrate a clinically significant association among severity measures.
在一项比较两种治疗压力性尿失禁手术技术（Burch阴道悬吊术与耻骨后阴道吊带术）的随机临床试验中，我们评估了以压力性症状为主的女性尿失禁严重程度指标之间的关系。
共有655名女性接受了标准化的术前评估，包括衰老的医学、流行病学和社会方面问卷、泌尿生殖系统困扰量表、尿失禁影响问卷、3天排尿日记、24小时护垫试验、仰卧位膀胱空虚时压力试验以及瓦尔萨尔瓦漏尿点压力测量。使用Spearman相关系数和95%置信区间估计相关性。进行α=0.05的t检验，以比较仰卧位膀胱空虚时压力试验阳性和阴性患者之间连续严重程度指标的分布。
衰老的医学、流行病学和社会方面问卷、泌尿生殖系统困扰量表和尿失禁影响问卷的基线平均得分分别为25.8、151和171。平均尿失禁发作频率和护垫重量分别为每天3.2次和43.5克。218例患者仰卧位膀胱空虚时压力试验呈阳性，428例患者有有效的瓦尔萨尔瓦漏尿点压力测量值，平均瓦尔萨尔瓦漏尿点压力为80 cm H₂O。在衰老的医学、流行病学和社会方面问卷、尿失禁发作频率、护垫重量、尿失禁影响问卷和泌尿生殖系统困扰量表之间观察到弱至中度相关性。另一方面，瓦尔萨尔瓦漏尿点压力与所有测量变量的相关性较差。仰卧位膀胱空虚时压力试验预测固有括约肌功能障碍的敏感性和特异性分别为49%和60%。
尿失禁严重程度指标之间充其量只有中度相关性。虽然衰老的医学、流行病学和社会方面问卷与其他严重程度和生活质量指标显示出更强的相关性，但瓦尔萨尔瓦漏尿点压力并非如此。仰卧位膀胱空虚时压力试验在严重程度指标之间未显示出临床显著关联。
