Predictive value of prolapse symptoms: a large database study
Predictive value of prolapse symptoms: a large database study
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DOI：
10.1007/s00192-004-1243-8
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发表时间：
2005-06-01
影响因子：
1.8
通讯作者：
Nager, CW
中科院分区：
文献类型：
--
作者：
Tan, JS;Lukacz, ES;Nager, CW
我们试图描述患者症状和盆腔器官脱垂（POP）之间的关系，并报告这些POP症状的敏感性，特异性，阳性和阴性预测值。两名泌尿科医生和四名泌尿妇科医生开发了一个标准化的盆底调查问卷的基础上，在三个女性盆底疾病诊所使用的面部验证。与脱垂相关的具体问题包括尿夹板固定、排便时的手指辅助和阴道隆起。采用标准化盆腔器官脱垂定量（POP-Q）术语评估脱垂。该分析包括1912名女性。当Ba< 0时，尿夹板不常见（< 10%），但III期和IV期Ba脱垂的范围为23%至36%。在II期Bp脱垂（21 - 38%）和III-IVBp脱垂（26 - 29%）中，手指辅助同样常见。只有6 - 11%的0期或I期POP女性报告了肿胀症状，但II期增加到77%。尿夹板固定对前脱垂的特异性为97%。隆起的报告具有81%的阳性预测值和76%的阴性预测值。很少有没有前脱垂的患者会报告尿夹板。手指协助排便在重度后脱垂患者中并不比中度后脱垂患者更常见。病人报告的一个隆起是一个有价值的筛选工具，POP，并应提示仔细检查。
We sought to describe the relationship between patient symptoms and pelvic organ prolapse ( POP) and report the sensitivity, specificity, and positive and negative predictive value of these POP symptoms. Two urologists and four urogynecologists developed a standardized pelvic floor questionnaire based on face validation for use at three female pelvic floor disorder clinics. Specific questions related to prolapse included questions on urinary splinting, digital assistance for defecation, and a bulge per vagina. Prolapse was assessed with the standardized Pelvic Organ Prolapse Quantitative (POP-Q) terminology. The analysis included 1912 women. Urinary splinting was uncommon (< 10%) when Ba< 0, but ranged between 23 and 36% for stage III and IV Ba prolapse. Digital assistance was equally common in stage II Bp prolapse ( 21 - 38%) and stage III-IVBp prolapse ( 26 - 29%). Only 6 - 11% of women with stage 0 or I POP reported symptoms of bulge, but with stage II it increased to 77%. Urinary splinting is 97% specific for anterior prolapse. The report of a bulge has an 81% positive predictive value and a 76% negative predictive value. Very few patients without anterior prolapse will report urinary splinting. Digital assistance for fecal evacuation is no more common with massive posterior prolapse than with moderate posterior prolapse. Patient report of a bulge is a valuable screening tool for POP and should prompt a careful exam.