From the Department of Urology, Miller School of Medicine, University of Miami, Miami, FL.
Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Female Pelvic Med Reconstr Surg. 2021 Jan 1;27(1):e127-e132. doi: 10.1097/SPV.0000000000000858.
The aim of the study was to compare which test is most sensitive in identifying stress urinary incontinence (SUI) in women with pelvic organ prolapse using urodynamics (UDS) as the criterion standard: cough stress test (CST) or pyridium pad test.
This was a prospective study of women with pelvic organ prolapse stage II or greater who desired surgical management for prolapse. Each patient underwent preoperative urinary testing: UDS, CST, and a 24-hour pyridium pad test.
A total of 84 patients were analyzed. Using UDS as the criterion standard, both the CST and the pyridium pad test showed a fair agreement with UDS outcomes (κ = 0.27 for both tests). There was no statistically significant difference between the CST and the pyridium pad test, with estimated sensitivities of 34.4% versus 40.6% (P = 0.791), specificities of 90.4% versus 84.6% (P = 0.508). The pyridium pad test was found to have a statistically significant difference in identifying the subjective complaint of SUI (38.6%, P = 0.003) compared with other tests. Patients with occult incontinence were identified 42.5%, 17.5%, and 10% of the time during UDS, CST, and pyridium pad testing, respectively.
Our data suggest that the sensitivities of the CST and pyridium pad test for stress incontinence and occult stress incontinence in patients with pelvic organ prolapse are low when compared with UDS as the criterion standard. Urodynamics has an important role in preoperative identification of occult SUI.
本研究旨在比较在以尿动力学（UDS）为标准的情况下，哪种测试对诊断盆腔器官脱垂女性的压力性尿失禁（SUI）最敏感：咳嗽压力测试（CST）或匹鲁米特垫测试。
这是一项针对 II 期或更高级别盆腔器官脱垂且希望手术治疗脱垂的女性的前瞻性研究。每位患者均接受术前尿测试：UDS、CST 和 24 小时匹鲁米特垫测试。
共分析了 84 例患者。以 UDS 为标准，CST 和匹鲁米特垫测试与 UDS 结果均显示出适度的一致性（两种测试的κ值均为 0.27）。CST 和匹鲁米特垫测试之间无统计学差异，估计敏感性分别为 34.4%和 40.6%（P=0.791），特异性分别为 90.4%和 84.6%（P=0.508）。与其他测试相比，匹鲁米特垫测试在识别 SUI 的主观症状方面具有统计学意义（38.6%，P=0.003）。在 UDS、CST 和匹鲁米特垫测试中，分别有 42.5%、17.5%和 10%的隐匿性尿失禁患者被识别。
与 UDS 作为标准相比，CST 和匹鲁米特垫测试在诊断盆腔器官脱垂患者的压力性尿失禁和隐匿性压力性尿失禁方面的敏感性较低。UDS 在术前识别隐匿性 SUI 方面具有重要作用。
