Office cystometry in a resource-constrained setting: Spectrum of diagnoses and correlation with QUID

S. Bola-Oyebamiji, O. Badejoko, I. Awowole, Z. Abdur-Rahim, M. Ajayi, A. Salako
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Abstract

Background: Office cystometry is an appropriate technology alternative to urodynamics, especially in resource-poor settings. The combination of a validated screening tool such as the Questionnaire for Urinary Incontinence Diagnosis (QUID) and office cystometry stands as the gold standard in the evaluation of urinary incontinence, where urodynamics is not available. Objectives: This study aimed to determine the spectrum of urinary incontinence diagnoses using a combination of urogynecological examination and office cystometry among women in a resource-constrained sub-Saharan African setting and to correlate this with their QUID diagnoses. Methods: Sixty consenting women who had urinary incontinence diagnosed with QUID were recruited from a related study. The cough stress test was performed to elicit stress incontinence. Standard digital and speculum examinations were performed. Postvoid residual urine volume was determined by catheterization. Simple cystometry was performed to detect detrusor overactivity. Using urogynecological examination and simple cystometry as the gold standard, sensitivity, specificity, positive, and negative predictive values were calculated for QUID. Results: The spectrum of diagnoses made using urogynecological examination and office cystometry included no incontinence 13 (21.7%), urge incontinence 23 (38.3%), stress incontinence 18 (30.0%), mixed incontinence 5 (8.3%), and overflow incontinence in 1 (1.7%) woman, respectively. Using this as the gold standard, QUID demonstrated sensitivity of 87.0%, 55.6%, and 60.0% for urge, stress, and mixed incontinence, respectively, with corresponding specificity of 73.0%, 81.0%, and 83.6%, respectively. Conclusion: Urogynecological examination and office cystometry identified stress, urge, mixed, and overflow urinary incontinence in the study population. Overall, good correlation existed between the QUID and office cystometric diagnoses.
资源受限环境下的办公室膀胱术:诊断谱及与QUID的相关性
背景:办公室膀胱测量是泌尿动力学的一种合适的替代技术,特别是在资源贫乏的环境中。结合有效的筛查工具,如尿失禁诊断问卷(QUID)和办公室膀胱测定法,在尿动力学不可用的情况下,作为尿失禁评估的金标准。目的:本研究旨在确定在资源受限的撒哈拉以南非洲地区妇女中使用泌尿妇科检查和办公室膀胱测定相结合的尿失禁诊断谱,并将其与QUID诊断相关联。方法:从一项相关研究中招募了60名同意诊断为QUID的尿失禁妇女。咳嗽压力测试诱发应激性尿失禁。进行标准指镜检查。空后残余尿量通过导尿法测定。简单膀胱术检测逼尿肌过度活动。以泌尿妇科检查和简单膀胱术为金标准,计算QUID的敏感性、特异性、阳性预测值和阴性预测值。结果:通过泌尿妇科检查和办公室膀胱检查,诊断出无尿失禁13例(21.7%),急迫性尿失禁23例(38.3%),压力性尿失禁18例(30.0%),混合性尿失禁5例(8.3%),溢流性尿失禁1例(1.7%)。以此为金标准,QUID对急尿、压力性尿失禁和混合性尿失禁的敏感性分别为87.0%、55.6%和60.0%,特异性分别为73.0%、81.0%和83.6%。结论:泌尿妇科检查和办公室膀胱检查在研究人群中发现了应激性、急迫性、混合性和溢出性尿失禁。总体而言,QUID与办公室膀胱测量诊断之间存在良好的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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