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.

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