The effect of patient position on proximal urethral mobility.
OBJECTIVE
To determine the effect of patient position on the mobility of the urethrovesical junction.


METHODS
Q-tip tests in the supine and standing positions were performed on forty-six consecutive female patients with a variety of urogynecologic complaints. Wilcoxon signed-rank test and McNemar test were used to compare urethral mobility in the supine and standing positions.


RESULTS
Both the maximum straining Q-tip angle and the difference between the resting and straining angles were significantly greater in the supine position than in the standing position (P < .01). Thirty-four subjects had a positive Q-tip test in the supine position (defined as a maximal straining angle of at least 30 degrees), but only 24 (71%) of these women had a positive Q-tip test in the standing position.


CONCLUSIONS
Patient position has a significant effect on mobility of the urethrovesical junction, in that the female urethra is more mobile in the supine than in the standing position. Because the selection of a surgical procedure for a woman with genuine stress incontinence depends in part on the presence or absence of urethral hypermobility, this observation has important implications for the evaluation of women with genuine stress incontinence.
Handa
V L
VL
Department of Obstetrics and Gynecology, Long Beach Memorial Medical Center, California, USA.
Jensen
J K
JK
Ostergard
D R
DR
D005260:Female; D006801:Humans; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D016683:Supine Position / Q000502:physiology; D014521:Urethra / Q000503:physiopathology* / Q000601:surgery; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery