Sand P K, Hill R C, Ostergard D R
Department of Obstetrics and Gynecology, Women's Hospital, Memorial Medical Center of Long Beach, University of California, Irvine.
Obstet Gynecol. 1988 Feb;71(2):257-60.
Between January 1983 and July 1985, 218 women underwent preliminary evaluation and urodynamic testing in our laboratory. Their symptoms and urodynamic diagnoses were compared to evaluate the ability of a patient's history to predict the stability of the detrusor. The symptom of stress incontinence was a sensitive detector of genuine stress incontinence (100% sensitivity) but was not very specific (65.2%). The symptoms of urgency and urge incontinence were found to have limited sensitivity (77.9%) and specificity (38.7%) in the detection of detrusor instability. Even patients with isolated complaints of stress incontinence had an incidence of detrusor instability of 34.9%, whereas 76.9% of those with a history of isolated urgency and urge incontinence had detrusor instability. Three percent of patients complaining of either type of incontinence had no objective evidence of incontinence on urodynamic investigation. The results of this study demonstrate that a patient's history is a poor predictor of the underlying cause of incontinence.
1983年1月至1985年7月期间，218名女性在我们实验室接受了初步评估和尿动力学检测。将她们的症状和尿动力学诊断结果进行比较，以评估患者病史对预测逼尿肌稳定性的能力。压力性尿失禁症状是真性压力性尿失禁的敏感检测指标（敏感性为100%），但特异性不强（65.2%）。发现尿急和急迫性尿失禁症状在检测逼尿肌不稳定方面敏感性有限（77.9%），特异性也有限（38.7%）。即使是仅有压力性尿失禁主诉的患者，逼尿肌不稳定的发生率也为34.9%，而有孤立尿急和急迫性尿失禁病史的患者中，76.9%有逼尿肌不稳定。抱怨任何一种尿失禁类型的患者中，3%在尿动力学检查中没有尿失禁的客观证据。本研究结果表明，患者病史对尿失禁潜在病因的预测能力较差。
