Bergman A, Bader K
Department of Obstetrics and Gynecology, USC School of Medicine, Women's Hospital, Los Angeles 90033.
Int J Gynaecol Obstet. 1990 Jul;32(3):255-9. doi: 10.1016/0020-7292(90)90354-n.
The reliability of a patient's history has been challenged in the preoperative evaluation of stress urinary incontinence. In this study, 122 consecutive patients referred to our Gynecology/Urology clinic were evaluated and an additional 32 control patients (continent women with no urinary symptoms) were evaluated. All patients answered a detailed 64-item questionnaire, and all patients received a complete urodynamic evaluation. Our detailed questionnaire provided a mean positive predictive value of 80% for genuine stress incontinence and 25% for detrusor instability. The conditions leading to a false positive history suggestive of genuine stress incontinence were detrusor instability and urethral diverticulum. The conditions leading to a false positive history suggestive of detrusor instability were urethritis, unstable urethra, vaginitis and polyuria. History alone can be misleading in diagnosing urinary incontinence.
在压力性尿失禁的术前评估中，患者病史的可靠性受到了挑战。在本研究中，对连续转诊至我们妇科/泌尿科诊所的122例患者进行了评估，并额外评估了32例对照患者（无泌尿症状的 continent 女性）。所有患者均回答了一份详细的64项问卷，并且所有患者都接受了完整的尿动力学评估。我们详细的问卷对真性压力性尿失禁的平均阳性预测值为80%，对逼尿肌不稳定的平均阳性预测值为25%。导致提示真性压力性尿失禁的假阳性病史的情况是逼尿肌不稳定和尿道憩室。导致提示逼尿肌不稳定的假阳性病史的情况是尿道炎、尿道不稳定、阴道炎和多尿。仅靠病史在诊断尿失禁时可能会产生误导。
