Sand P K, Brubaker L T, Novak T
Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois.
Obstet Gynecol. 1991 Mar;77(3):453-7.
One hundred consecutive neurologically normal women complaining of urinary incontinence underwent standing incremental retrograde medium-fill water cystometrograms on two different days followed by sitting and standing continuous retrograde medium-fill water urethrocystometry on a third visit between November 1987 and February 1989. Studies were done to assess the reproducibility, sensitivity, specificity, and predictive values of a simple cystometer. Standing incremental, retrograde cystometry was found to be relatively inexpensive, simple, reproducible, and sensitive. The two cystometrograms yielded similar results in 84% of the patients. The sensitivities were found to be 84.3 and 90.2% for the first and second cystometrograms, respectively. Using both cystometrograms together, we were able to detect detrusor instability with a sensitivity of 92.3% and to predict its absence with a negative predictive value of 86.7%. Detrusor instability was found in 64% of these patients. Based on these results, it was concluded that when multichannel urodynamics are not available in a high-prevalence population, standing retrograde incremental water cystometry done on two occasions may offer the physician an accurate alternative for the diagnosis of detrusor instability.
1987年11月至1989年2月期间，100名连续的主诉尿失禁但神经系统正常的女性，在两天内分别接受了站立位递增逆行中等量充盈膀胱测压检查，然后在第三次就诊时接受了坐位和站立位连续逆行中等量充盈尿道膀胱测压检查。进行这些研究是为了评估一种简单膀胱测压仪的可重复性、敏感性、特异性和预测价值。发现站立位递增逆行膀胱测压相对便宜、简单、可重复且敏感。在84%的患者中，两次膀胱测压结果相似。第一次和第二次膀胱测压的敏感性分别为84.3%和90.2%。将两次膀胱测压结果结合起来，我们能够以92.3%的敏感性检测逼尿肌不稳定，并以86.7%的阴性预测值预测其不存在。在这些患者中，64%发现有逼尿肌不稳定。基于这些结果，得出结论：在高患病率人群中若无法进行多通道尿动力学检查，两次进行站立位逆行递增水膀胱测压可为医生提供诊断逼尿肌不稳定的准确替代方法。
