| Office based criteria for predicting type II stress incontinence without further evaluation studies. | |
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MedLine Citation:
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PMID: 10081882 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The 1996 Agency for Health Care Policy and Research Clinical Practice Guidelines for Urinary Incontinence suggested that surgery may be performed after basic evaluation without further testing in cases of uncomplicated nonrecurrent type II stress urinary incontinence. However, they failed to recommend explicit office based criteria to identify this condition without further invasive testing. We establish such criteria and test the efficacy. MATERIALS AND METHODS: Records of 101 women with urinary incontinence who underwent complete evaluation from June 1995 to September 1997 were reviewed. Basic evaluation consisted of medical history, physical/pelvic examination and the validated Medical, Epidemiologic and Social Aspects of Aging Urinary Incontinence Questionnaire, while further testing included cystourethroscopy, urodynamics and lateral stress cystogram. All cases diagnosed as pure type II stress urinary incontinence after basic and further testing were identified, and office based findings were characterized, which included medical history, questionnaire scores, vaginal speculum examination results and post-void residual urine volume. These criteria were applied in a blinded fashion to the initial group of 101 patients and then to a new group of 45 women with incontinence who recently underwent complete evaluation. RESULTS: Specificity and positive predictive value were 100% in both groups for nonsurgical cases, compared to 81 and 71% in the initial, and 75 and 60% in the new group, respectively, for surgical cases. Conclusions: Our office based criteria are 100% specific for predicting pure type II stress urinary incontinence in women with no suspension surgery and, thus, have the potential of reducing the need for further invasive testing and consequently the cost of preoperative evaluation. |
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Authors:
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A C Diokno; R R Dimaculangan; E U Lim; B W Steinert |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of urology Volume: 161 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-04-16 Completed Date: 1999-04-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1263-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Humans Office Visits Predictive Value of Tests Questionnaires Sensitivity and Specificity Severity of Illness Index Urinary Incontinence, Stress / classification, diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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