'The cough game': Are there characteristic urethrovesical movement patterns associated with stress incontinence? Academic Article uri icon


MeSH Major

  • Cough
  • Pelvic Floor
  • Urethra
  • Urinary Incontinence, Stress


  • 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.

publication date

  • January 28, 2009



  • Academic Article



  • eng

PubMed Central ID

  • PMC2752750

Digital Object Identifier (DOI)

  • 10.1007/s00192-008-0738-0

PubMed ID

  • 18850057

Additional Document Info

start page

  • 171

end page

  • 5


  • 20


  • 2