163 Role of the hypermobility and provocative stress tests in the diagnosis of stress incontinence in females

163 Role of the hypermobility and provocative stress tests in the diagnosis of stress incontinence in females Ismayil V.1, Demirkesen O.2, Cetinel B.2 1 Azerbaijan Medical University, Dept. of Urology, Baku, Azerbaijan, 2University of Istanbul, School of Medicine of Cerrahpasa, Dept. of Urology, Istanbul, Turkey INTRODUCTION & OBJECTIVES: To investigate the role of hypermobility and provocative stress tests in the evaluation of the stress incontinence in adult females. MATERIAL & METHODS: All female patients older than 16 years with urinary incontinence referred to the urodynamic unit of the Medical School of Cerrahpasa were conducted retrospectively. Patients with local or neurogenic bladder disorders, extraurethral urinary incontinence are dropped off the study. After taking detailed story metal bougie with olive tip was used to test urethral hypermobility. All measures were done by observation. Displacements higher than 300 were accepted as a positive result. Provocative stress test (PST) was performed with bladder filled to capacity in 450 decubitus position. The test repeated in standing position Observation of urine leakage in any position was accepted as a positive result. Urodynamic tests were performed according standards of the International Continence Society (ICS). Patients with not correctly detected Valsalva Leak Point Pressure (VLPP) values were dropped out of research’s scope Of the totally 351 investigated patients urodynamic finding was as Detrusor Overactivity (DO) in 101, as Urodynamic Stress Incontinence (USI) in 175, DO+USI in 75. All patients were investigated in two groups. Group 1 included only DO cases. All the USI cases were evaluated in Group 2. RESULTS: Of the totally 351 patients with a mean age 51±14.1 years hypermobility test result was as positive in 74 (21%), as negative in 90 (25.6). Test was not performed in 187 (53.3%) patients. PST result was found as negative in 79 (22.5%), as positive in 229 (65.25%) patients. Test was not performed in 43 (12.25%) patients. Hypermobility test and PST results for both Group 1 and 2 are listed in Table 1. Group 1 (n/%) Group 2 (n/%) Total (n) Hypermobility (-) 27 (%36.5) 47 (%63.5) 74 Hypermobility (+) 24 (%26.7) 66 (%73.3) 90 PST (-) 46 (%58.2) 33(%41.75) 79 PST (+) 35 (%15.3) 194 (%84.7) 229 Table 1. Sensitivity, spesivity, predictivity and accuracy values are listed in Table 2. Hypermobility - USI PST- USI Sensitivity 51.3 85.5 Spesivity 49.7 56.8 Positive Predictive Value 44.4 84.7 Negative Predictive Value 56.6 58.2 Accuracy 50.4 77.9 Table 2. CONCLUSIONS: Hypermobility test is not gave us reliable information about urodynamic diagnosis. PST has a good sensitivity, but poor spesivity, so it’s necessary to perform urodynamic tests.

Eur Urol Suppl 2015; 14(8): e1441