Significance of the Negative Q-tip Test as a Risk Factor for Failed Incontinence Surgery

Bae, S W; Yeon, J E; Jung, B H; Yang, S C; Lee, M S; Park, K H

Abstract

OBJECTIVE
To determine whether the surgical procedures that lift and support the urethrovesical junction to its high position are effective in treating women with stress urinary incontinence and a negative Q-tip test.
METHODS
Thirty two women with a clinical and urodynamic diagnosis of stress urinary incontinence who had a negative Q-tip test[<30degreesQ-tip angle change on straining] were enrolled in this study. Among 32 patients, 21 patients had Burch operation and 11 patients had anterior repair. We obtained failure rate of Burch operation and anterior repair in patients with a negative Q-tip test and compared it with patients with a positive Q-tip test.
RESULTS
Ten of twenty one patients undergoing Burch operation[48%] and five of eleven patients undergoing anterior repair[45%] failed the operation, for overall failure rate of 47%. This rate was three and half times higher than that among with stress urinary incontinence and a positive Q-tip test who underwent the same procedures[p<0.05].
CONCLUSION
Women with stress urinary incontinence and no anatomic defect in the support of the urethrovesical junction should not undergo a traditional anti-incontinence surgeries because of their high failure rate.