The reliability of performing a screening cystometrogram using a fetal monitoring device for the detection of detrusor instability.
OBJECTIVE
To determine if a cystometrogram performed using the intrauterine pressure channel of a fetal monitor can be used to screen for detrusor instability in women undergoing evaluation for urinary incontinence.


METHODS
Sixty-six women with primary complaints of urinary incontinence were randomized to have a cystometrogram performed at their initial visit with a multichannel electronic cystometer or with the intrauterine pressure channel of a fetal monitor. Subjects underwent a second cystometrogram 1-4 weeks later with the alternative technique. The results were analyzed with chi 2 analysis and correlation coefficients.


RESULTS
Twenty-two subjects had detrusor instability diagnosed by the multichannel electronic cystometer. The fetal monitor cystometrogram was 91% sensitive and 86% specific in detecting detrusor instability, and had a 77% positive predictive value and a 95% negative predictive value. The correlation coefficients between the two examinations for bladder volume at first sensation, maximum capacity, volume at first contraction, and intensity of uninhibited detrusor contraction were r = 0.51, r = 0.69, r = 0.87, and r = 0.79, respectively; all of these were statistically significant.


CONCLUSIONS
The intrauterine pressure channel of a fetal monitor can be used reliably to perform a cystometrogram to screen for detrusor instability in patients presenting with complaints of urinary incontinence.
Swift
S E
SE
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, USA.
D018592:Cross-Over Studies; D005260:Female; D005323:Fetal Monitoring / Q000295:instrumentation*; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014160:Transducers, Pressure / Q000592:standards*; D014549:Urinary Incontinence / Q000175:diagnosis*; D014563:Urodynamics