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“The cough game”: are there characteristic urethrovesical movement patterns associated with stress incontinence?

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Abstract

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.

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Abbreviations

SUI:

stress urinary incontinence

MUCP:

maximum urethral closure pressure

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Funding

We acknowledge research support from the Office for Research on Women’s Health SCOR on Sex and Gender Factors Affecting Women’s Health and the National Institute of Child Health and Human Development 1 P50 HD044406.

Conflicts of interest

None.

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Authors and Affiliations

  1. Division of Gynecology, Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA

    Christina Lewicky-Gaupp, Julie Tumbarello & John O. L. DeLancey

  2. Department of Urology, New York-Presbyterian/Weill Cornell, New York, NY, USA

    Jerry Blaivas

  3. Division of Gynecology, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR, USA

    Amanda Clark

  4. Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA

    Edward J. McGuire

  5. Department of Obstetrics and Gynecology, Kantonsspital Aarau, Aarau, Switzerland

    Gabriel Schaer

  6. Department of Urogynecology, German Pelvic Floor Center, St. Hedwig Hospitals, Berlin, Germany

    Ralf Tunn

  7. 1500 East Medical Center Dr., Women’s Hospital L4100, Ann Arbor, MI, 48109-0276, USA

    Christina Lewicky-Gaupp

Authors
  1. Christina Lewicky-Gaupp
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  2. Jerry Blaivas
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  3. Amanda Clark
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  4. Edward J. McGuire
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  5. Gabriel Schaer
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  6. Julie Tumbarello
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  7. Ralf Tunn
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  8. John O. L. DeLancey
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Corresponding author

Correspondence to Christina Lewicky-Gaupp.

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Lewicky-Gaupp, C., Blaivas, J., Clark, A. et al. “The cough game”: are there characteristic urethrovesical movement patterns associated with stress incontinence?. Int Urogynecol J 20, 171–175 (2009). https://doi.org/10.1007/s00192-008-0738-0

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  • DOI: https://doi.org/10.1007/s00192-008-0738-0

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