Changes in the Q-tip angle in relation to the patient position and bladder filling

초록

Background: It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result. This study evaluated the effect of the patient position and bladder filling status on the Q-tip angle for urethral hypermobility (UH). Methods: There was a measurement of the Q-tip angle in the supine position and at a 45 degrees angle in a reclining position during bladder emptying; and then the measurements were repeated while filling the bladder. We defined urethral hypermobility as the urethral angle straining or coughing minus that at rest >= 30 degrees. Results: All 63 female patients (mean age: 61.6 years, range: 36-81) who complained of urinary incontinence were assessed using the Q-tip angle test. The pelvic organ prolapse quantification stages of all patients were <= stage 1. The mean Q-tip angle with an empty bladder was 14.1 +/- 9.1 degrees in the supine position and 16.4 +/- 11.1 degrees in the reclining position (p = 0.001). Then mean Q-tip angle during the filling bladder state was 15.4 +/- 9.7 degrees in the supine position and 15.9 +/- 11.0 degrees in the reclining position (p = 0.771). The UH rate during the bladder emptying state was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The UH rate during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the 45 degrees reclining position. The odds ratio (OR) was 7.03 in the reclining position for a positive Q-tip angle. The positive rate was higher in the 45 degrees reclining position during bladder emptying than that in the other position during bladder filling. Conclusion: The outcome of the Q-tip angle and the rate of UH changed in relation to patient position. The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.

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