Can we use a catheter to do the q-tip test?
OBJECTIVE
To compare two commonly used modifications to the standard Q-tip test for urethral hypermobility: catheter alone and catheter with Q-tip.


METHODS
All women referred for the evaluation of urinary incontinence or pelvic organ prolapse were included in the study. A postvoid residual urine was collected on each patient and the angle of the urethra with the horizontal plane was measured at rest and with Valsalva with the Q-tip, catheter alone, and catheter with Q-tip. The test was considered positive if the angle of excursion was 30 degrees or more.


RESULTS
In this group of 100 consecutive women with urinary incontinence or pelvic organ prolapse, the mean change in the angle was significantly different from the standard Q-tip test (51 degrees) when catheter alone (35 degrees, P<.001) or catheter with Q-tip modifications were used (44 degrees, P<.001). This difference was due to a significant reduction in the resting and Valsalva maneuver angles with the catheter alone, and a significant decrease only in the Valsalva maneuver angle with the catheter with Q-tip method (P<.001). The percentage of positive tests for the standard Q-tip test (92%) was significantly different from the catheter only method (63%, P<.001), and from the catheter with Q-tip technique (83%, P=.021). The "best match" values of 10 degrees for the catheter alone, and 15 degrees for the catheter with Q-tip methods produce the best equivalent results at this time.


CONCLUSIONS
The use of a catheter, instead of a Q-tip, in the evaluation of urethral hypermobility resulted in reduced angles of excursion from resting to Valsalva maneuver.


METHODS
III.
Weber Lebrun
Emily E
EE
Department of Obstetrics and Gynecology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199, USA.
Harmanli
Ozgur H
OH
Lidicker
Jeffrey
J
Dandolu
Vani
V
D000328:Adult; D000368:Aged; D003950:Diagnostic Techniques, Urological / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000175:diagnosis*; D014636:Valsalva Maneuver