Q-Tip test in female urinary incontinence.

The Q-Tip test, an inexpensive and widely used clinical investigative tool, was reevaluated as to diagnostic worth. One hundred patients were investigated with cystometergrams or videocystourethrography, and all patients underwent a standardized Q-Tip test. Thirty-two percent of patients with a positive Q-Tip test had either pure detrusor instability or pure sensory urgency as the diagnosis for urinary incontinence. Twenty-nine percent of patients who had a negative Q-Tip test had a diagnosis of pure genuine stress incontinence. The Q-Tip test was more likely to be positive in younger patients with a cystourethrocele who had undergone less bladder neck surgery. This study demonstrates the limitations of the Q-Tip test and reconfirms the need for more sensitive and specific urodynamic investigations of the incontinent woman.