title: Changes in the Q-tip angle in relation to the patient position and bladder filling.
abstract: BACKGROUND
  It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result. This study evaluated the effect of the patient position and bladder filling status on the Q-tip angle for urethral hypermobility (UH).
  
  
  METHODS
  There was a measurement of the Q-tip angle in the supine position and at a 45° angle in a reclining position during bladder emptying; and then the measurements were repeated while filling the bladder. We defined urethral hypermobility as the urethral angle straining or coughing minus that at rest ≥ 30°.
  
  
  RESULTS
  All 63 female patients (mean age: 61.6 years, range: 36-81) who complained of urinary incontinence were assessed using the Q-tip angle test. The pelvic organ prolapse quantification stages of all patients were ≤ stage 1. The mean Q-tip angle with an empty bladder was 14.1 ± 9.1° in the supine position and 16.4 ± 11.1° in the reclining position (p = 0.001). Then mean Q-tip angle during the filling bladder state was 15.4 ± 9.7° in the supine position and 15.9 ± 11.0° in the reclining position (p = 0.771). The UH rate during the bladder emptying state was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The UH rate during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the 45° reclining position. The odds ratio (OR) was 7.03 in the reclining position for a positive Q-tip angle. The positive rate was higher in the 45° reclining position during bladder emptying than that in the other position during bladder filling.
  
  
  CONCLUSIONS
  The outcome of the Q-tip angle and the rate of UH changed in relation to patient position. The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.
authors.affiliation: Department of Urology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, South Korea. dulitle@daum.net.
authors.forename: Jong-hyun
authors.initials: JH
authors.lastname: Yun
authors.affiliation: Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul, South Korea. piacekjh@hanmail.net.
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, Soonchunhyang University Hospital, Seoul, South Korea. suyeon1002@schmc.ac.kr.
authors.forename: Suyeon
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, 31 Soonchunhyang 6 gil, Dongnam-Gu, Cheonan, Chungcheongnam-do, 330-721, South Korea. leech@sch.ac.kr.
authors.forename: Changho
authors.initials: C
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000502:physiology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000503:physiopathology*; D014563:Urodynamics