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

Lewicky-Gaupp C, Blaivas J, Clark A, McGuire EJ, Schaer G, Tumbarello J, Tunn R, DeLancey JO

International urogynecology journal and pelvic floor dysfunction, 2009

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.

How strong is the evidence?

Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

• DOI
• PubMed
• Publisher page

Related studies

• Understanding the factors influencing fall armyworm (Spodoptera frugiperda J.E. Smith) damage in African smallholder maize fields and quantifying its impact on yield. A case study in Eastern Zimbabwe Crop Protection, 2019
• Alarming situation of emerging H5 and H7 avian influenza and effective control strategies Emerging Microbes and Infections, 2022
• Livestock and food security: vulnerability to population growth and climate change Global Change Biology, 2014
• Atmosphere–ocean oxygen and productivity dynamics during early animal radiations Proceedings of the National Academy of Sciences of the United States of America, 2019
• Characterization of the global distribution and diversified plasmid reservoirs of the colistin resistance gene mcr-9 Scientific Reports, 2020
• The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis Veterinary parasitology, 2019

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free