"The cough game": are there characteristic urethrovesical movement patterns associated with stress incontinence?
This study was carried out to determine whether five experts in female stress urinary incontinence (SUI) could discover a pattern of urethrovesical movement characteristic of SUI on dynamic perineal ultrasound. A secondary analysis of data from a case-control study was performed. Ultrasounds from 31 cases (daily SUI) and 42 controls (continent volunteers) of similar age and parity were analyzed. Perineal ultrasound was performed during a single cough. The five experts, blinded to continence status and urodynamics, classified each woman as stress continent or incontinent. Correct responses ranged from 45.7% to 65.8% (mean 57.4 +/- 7.6). Sensitivity was 53.0 +/- 8.8% and specificity 61.2 +/- 12.4%. The positive predictive value was 48.8 +/- 8.2% and negative predictive value was 65.0 +/- 7.3%. Inter-rater reliability, evaluated by Cohen's kappa statistic, averaged 0.47 [95% CI 0.40-0.50]. Experts could not identify a pattern of urethrovesical movement characteristic of SUI on ultrasound.
Lewicky-Gaupp
Christina
C
Division of Gynecology, Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA. clewicky@med.umich.edu
Blaivas
Jerry
J
Clark
Amanda
A
McGuire
Edward J
EJ
Schaer
Gabriel
G
Tumbarello
Julie
J
Tunn
Ralf
R
DeLancey
John O L
JO
D000328:Adult; D016022:Case-Control Studies; D003371:Cough / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D018608:Ultrasonography, Doppler; D014521:Urethra / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology*