A Scored Storage Symptoms Questionnaire to Screen Urodynamic Stress Incontinence in Women with Overactive Bladder

以計分儲尿症狀問卷從膀胱過動症婦女篩選尿動力性應力尿失禁

陳慧毅(Huey-Yi Chen) ； 洪耀欽(Yao-Ching Hung) ； 楊東川(Tung-Chuan Yang) ； 葉聯舜(Lian-Shung Yeh) ； 張維君(Wei-Chun Chang)

《Mid-Taiwan Journal of Medicine》 11卷4期 (2006/12) Pp. 222-229

https://doi.org/10.6558/MTJM.2006.11(4).3

摘要

目的　本研究藉由得分的儲尿症狀問卷從膀胱過動症婦女篩選尿動力性應力尿失禁。
方法　共有238位膀胱過動症婦女參與此研究。問卷調查於訪員第一次面對面訪談中完戍。本研究針對問卷結果與婦科醫師依據尿動力學檢查所作的臨床診斷進行分析。
結果　尿動力性應力尿失禁婦女比無尿動力性應力尿失禁婦女具有較高的急迫性尿失禁得分、漏尿量得分、應力尿失禁得分和總得分，且具統計學上的意義。尿動力性應力尿失禁的風險是隨著應力尿失禁症狀的嚴重度而增加。如果我們使用總得分超過12分和應力尿失禁得分超過2分當作診斷尿動力性應力尿失禁的切點，其敏感度、專一性、肯定的預測值、否定的預測值和準確性分別為82%、85%、79%、87%和84%。為了測試計分儲尿症狀問卷對臨床重要變化的敏感度，比較接受尿動力性應力尿失禁手術治療成功的20位病人，在治療前和治療後6個月得分的改變，在儲尿症狀問卷的六個參數和總得分，皆有意義的減少。
結論　計分儲尿症狀問卷在決定下泌尿道儲尿症狀的改變是有價值的，而且它是預測尿動力性應力尿失禁的一個敏感方法。

關鍵字

膀胱過動症 ； 下泌尿道儲尿症狀 ； 儲尿症狀問卷的得分 ； 尿動力性應力尿失禁

並列摘要

Purpose. The aim of this study was to use the scored storage symptoms questionnaire to screen urodynamic stress incontinence (USI) in women with overactive bladder (OAB).
Methods. We randomly enrolled 238 women with OAB. Scored storage symptoms questionnaire scores (SSQS) were incorporated as part of independent history at the first consultation. The scores of each patient were analyzed and correlated with the gynecologist's clinical diagnosis, which was based on urodynamic findings.
Results. Subjects with USI had significantly higher urge incontinence scores, leakage amount scores, stress incontinence scores, and total scores than those without USI. The risk of USI increased with the severity of stress incontinence symptoms. By defining total scores over 12 and stress incontinence scores over 2 as the cut-off points for USI, we found that the SSQS had a sensitivity of 82%, a specificity of 85%, a positive predictive value (PPV) of 79%, a negative predictive value (NPV) of 87%, and an accuracy of 84%. To test the sensitivity of the SSQS to predict clinically important changes, the SSQS of 20 successfully treated patients were compared before and 6 months after surgical treatment of USI. There were significant decreases in values of all six parameters (frequency, nocturia, urgency, urge incontinence, leakage amount, and stress incontinence) and total scores.
Conclusions. The scored storage symptoms questionaire is of value in determining changes in the storage symptoms of the lower urinary tract, and is a sensitive method for predicting USI.

並列關鍵字

overactive bladder ； storage symptoms of lower urinary tract ； storage symptoms questionnaire score ； urodynamic stress incontinence