Diagnostic accuracy of visual urethral mobility exam versus Q-Tip test: a randomized crossover trial
American Journal of Obstetrics and Gynecology, 03/05/2012

Robinson BL et al. – Visual urethral mobility exam (VUME) is a diagnostic alternative to the Q–tip test for assessment of urethral hypermobility and is preferred by subjects.

• 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.

• 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.