Khan Muhammad Jamal, Omar Mohammad Ali, Laniado Marc
Department of Urology, Frimley Health NHS Foundation Trust Wexham Park Hospital Slough, Berkshire, United Kingdom.
Cent European J Urol. 2018;71(1):84-91. doi: 10.5173/ceju.2018.1622. Epub 2017 Feb 21.
There are limited studies evaluating the 3 Incontinence Questionnaire (3IQ) against urodynamics based diagnosis as a reference standard. The 3IQ has been proposed to be useful to evaluate women at the level of primary care. The aim of this study was to determine correlation between 3IQ and video-urodynamics (VUDS) in diagnosing types of urinary incontinence.
Prospective data was collected on 200 consecutive female patients referred by primary care physicians for urinary incontinence. The mean age was 55 years (range 15-83 years). The patients were evaluated using the 3IQ and video-urodynamics. The 3IQ-based diagnosis of type of female urinary incontinence was compared to VUDS-based results. Sensitivity, specificity, positive likelihood ratios and positive predictive values were calculated.
On 3IQ based self-evaluation, 28% of patients were classified as having stress urinary incontinence, 20% with urge incontinence and 40% with mixed incontinence. On video-urodynamics, urodynamic stress urinary incontinence (UDSUI) was detected in 56% of patients, detrusor overactivity (DO) in 15% and mixed urinary incontinence (MUI) in 19%. The 3IQ had a sensitivity and specificity respectively of 43% and 92% for UDSUI, 57% and 86% for DO and 58% and 64% for MUI. The corresponding positive likelihood ratios (CI, 95%) were 5.4 (CI 2.6 to 11.3) for stress urinary incontinence, 4.0 (CI 2.5 to 6.5) for DO and 1.62 (1.2 to 2.3) for MUI. The respective positive predictive values were 87% (CI 75% to 95%), 42% (CI 26% to 58%) and 28% (18% to 39%).
In our study population, stress urinary incontinence was reasonably well predicted by the 3IQ, but the questionnaire under-performed in the diagnoses of detrusor overactivity and mixed urinaryincontinence.
以尿动力学检查诊断结果作为参考标准,对3项尿失禁问卷(3IQ)进行评估的研究有限。3IQ已被认为有助于在初级保健层面评估女性患者。本研究的目的是确定3IQ与影像尿动力学检查(VUDS)在诊断尿失禁类型方面的相关性。
前瞻性收集了由初级保健医生转诊的200例连续性女性尿失禁患者的数据。平均年龄为55岁(范围15 - 83岁)。使用3IQ和影像尿动力学检查对患者进行评估。将基于3IQ的女性尿失禁类型诊断结果与基于VUDS的结果进行比较。计算敏感性、特异性、阳性似然比和阳性预测值。
基于3IQ的自我评估,28%的患者被分类为压力性尿失禁,20%为急迫性尿失禁,40%为混合性尿失禁。在影像尿动力学检查中,56%的患者检测到尿动力学压力性尿失禁(UDSUI),15%为逼尿肌过度活动(DO),19%为混合性尿失禁(MUI)。3IQ对UDSUI的敏感性和特异性分别为43%和92%,对DO为57%和86%,对MUI为58%和64%。相应的阳性似然比(95%置信区间),压力性尿失禁为5.4(置信区间2.6至11.3),DO为4.0(置信区间2.5至6.5),MUI为1.62(1.2至2.3)。各自的阳性预测值分别为87%(置信区间75%至95%)、42%(置信区间26%至58%)和28%(18%至39%)。
在我们的研究人群中,3IQ对压力性尿失禁的预测较为合理,但该问卷在诊断逼尿肌过度活动和混合性尿失禁方面表现欠佳。