Diagnostic accuracy of visual urethral mobility exam versus Q-Tip test: a randomized crossover trial
American Journal of Obstetrics and Gynecology, 03/05/2012
Visual urethral mobility exam (VUME) is a diagnostic alternative to the Q–tip test for assessment of urethral hypermobility and is preferred by subjects. Methods Subjects were randomized to VUME or Q–tip test first, followed by the alternate assessment. Outcomes included hypermobile, not hypermobile, or indeterminate. Hypermobility was defined as ≥30° from the horizontal. Pain perception and test preference were assessed. Results
For the 54 subjects, 61.1% demonstrated hypermobility on VUME versus 72.2% on Q–tip test (p=0.39). Assessment of hypermobility was correlated between the two tools (ρ=0.47, p=0.001). Positive and negative predictive value, sensitivity, and specificity for VUME were 88%, 56%, 78%, and 71% respectively, with Q–tip test as the reference standard. Mean pain score on visual analog scale was 0.72 for VUME and 3.15 for Q–tip test (p<0.001). VUME was preferred by 83% of subjects.