Walters M D, Shields L E
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio 78284-7836.
Am J Obstet Gynecol. 1988 Jul;159(1):145-9. doi: 10.1016/0002-9378(88)90510-8.
One hundred six consecutive women who came to our clinic complaining of urinary incontinence underwent complete urodynamic evaluation. Urologic questions, pelvic examination findings, and the Q-tip cotton swab test results were examined to determine their ability to predict genuine stress incontinence (N = 59) versus other urologic disorders (N = 47). The symptom of stress incontinence, moderate to severe cystocele, and Q-tip cotton swab test result greater than or equal to 30 degrees were more common in women with genuine stress incontinence. Of the other urologic symptoms, only sensory urgency and enuresis were significantly associated with overactive detrusor function and voiding disorders. The combined findings of stress incontinence, cystocele, and no sensory urgency correctly identified 22% of women with genuine stress incontinence and eliminated 96% of women with other urologic disorders. Stress incontinence, moderate to severe cystocele, and no sensory urgency had a positive predictive value of 100%, but a sensitivity of only 10%. When used in series, the Q-tip cotton swab test contributed no additional information to that found by history taking and physical examination.
106名因尿失禁前来我院就诊的连续女性患者接受了全面的尿动力学评估。对泌尿系统相关问题、盆腔检查结果及棉签试验结果进行分析，以确定其预测真性压力性尿失禁（n = 59）与其他泌尿系统疾病（n = 47）的能力。压力性尿失禁症状、中重度膀胱膨出及棉签试验结果≥30°在真性压力性尿失禁女性中更为常见。在其他泌尿系统症状中，仅感觉性尿急和遗尿与逼尿肌过度活动功能及排尿障碍显著相关。压力性尿失禁、膀胱膨出及无感觉性尿急这一联合表现可正确识别22%的真性压力性尿失禁女性，并排除96%的其他泌尿系统疾病女性。压力性尿失禁、中重度膀胱膨出及无感觉性尿急的阳性预测值为100%，但敏感性仅为10%。串联使用时，棉签试验并未提供超出病史采集和体格检查的额外信息。
