Office screening test for intrinsic urethral sphincter deficiency: pediatric Foley catheter test.
OBJECTIVE
To evaluate an office-based test as a screening method for intrinsic sphincter deficiency.


METHODS
One hundred seventy-three women with urinary incontinence were evaluated prospectively by complete urodynamic studies. After catheterization, the pediatric Foley catheter test was performed on an empty bladder by withdrawing the inflated bulb of an 8-French Foley catheter through the urethra. The test was considered positive if the inflated catheter bulb could be withdrawn completely through the urethra. Women with grade 3 genital prolapse or higher were excluded. Intrinsic sphincter deficiency was defined as the presence of genuine stress incontinence and low maximum urethral closure pressure (at most 20 cm H(2)O).


RESULTS
Seventy-six of 173 women (44%) had positive tests and 97 (56%) had negative tests. Seventy-six percent of those with positive tests were diagnosed with intrinsic sphincter deficiency, compared with 19% in women with negative tests (P <.001). All women with positive tests and negative cotton swab tests had intrinsic sphincter deficiency. The sensitivity, specificity, and positive and negative predictive values for diagnosing intrinsic sphincter deficiency were 76, 81, 76, and 81%, respectively.


CONCLUSIONS
A positive pediatric Foley catheter test in the absence of urethral mobility strongly suggests intrinsic sphincter deficiency. The pediatric Foley catheter test may be useful in screening for intrinsic sphincter deficiency.
Arya
L A
LA
Division of Urogynecology, Department of Obstetrics and Gynecology, Brown University School of Medicine, Providence, Rhode Island, USA.
Myers
D L
DL
Jackson
N D
ND
D000368:Aged; D000553:Ambulatory Care; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal; D010372:Pediatrics; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014521:Urethra / Q000503:physiopathology*; D014546:Urinary Catheterization / Q000295:instrumentation*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000209:etiology; D014563:Urodynamics