Reliability and validity of stationary cystometry, stationary cysto-urethrometry and ambulatory cysto-urethro-vaginometry.

OBJECTIVE

The purpose of this article is to evaluate the reliability and validity of stationary cystometry, stationary cysto-urethrometry and ambulatory cysto-urethro-vaginometry for the diagnosis of urinary incontinence.

MATERIAL AND METHODS

Literature search on reproducibility of cystometry is based on articles written in the English language found in Medline from 1987 to 1993. Five articles were found. These articles had references for another 6 older articles about the same topic. One recently published article is evaluated as well. Data about reproducibility of cystometry performed in these studies are given. Knowledge of reproducibility of cystometry combined with urethrometry, urethro-vagino or rectometry with leak detection during stationary or ambulatory recording is given. An evaluation of validity of the different methods is presented.

RESULTS AND CONCLUSION

Conflicting data has been found for sensory parameters of stationary cystometry such as volume or pressure at first desire to void, strong desire to void and maximum cystometric capacity. No data were found concerning the reliability of cystometry for the recording of urinary incontinence. The main problem of urge-incontinent patients is leakage with a strong feeling of urgency. The recording of sensory parameters by cystometry is not valid when the main problem is urge incontinence. Cystometry will be valid for the diagnosis of urge incontinence when a leak detector is used or a mark is made at the tracings when leakage is observed. The reliability of cystometry concerning urge incontinence should be documented. The reliability of a urethral pressure recording when the urethral catheter is extracorporally fixed is low. The reliability and validity of ambulatory cysto-urethro-vaginometry in diagnosing urge incontinence, unstable urethra and genuine stress incontinence seems to be good, but needs better documentation.