Diagnostic accuracy of visual urethral mobility exam versus Q-Tip test: A randomized crossover trial

Barbara Lynn Robinson, Elizabeth Joanne Geller, Brent Ashley Parnell, Andrea Kuntaraf Crane, Mary Lee Jannelli, Ellen Casper Wells, Annamarie Connolly, Catherine Ann Matthews

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


OBJECTIVE: The objective of the study was to compare the diagnostic accuracy of a visual urethral mobility examination (VUME) with a Q-Tip test in the assessment of urethral hypermobility. STUDY DESIGN: Subjects were randomized to a VUME or Q-Tip test first, followed by the alternate assessment. Outcomes included hypermobile, not hypermobile, or indeterminate. Hypermobility was defined as 30° or greater from the horizontal. Pain perception and test preference were assessed. RESULTS: For the 54 subjects, 61.1% demonstrated hypermobility on VUME vs 72.2% on the Q-Tip test (P =.39). Assessment of hypermobility was correlated between the 2 tools (ρ = 0.47, P =.001). Positive and negative predictive value, sensitivity, and specificity for VUME were 88%, 56%, 78%, and 71%, respectively, with a Q-Tip test as the reference standard. Mean pain score on visual analog scale was 0.72 for VUME and 3.15 for Q-tip test (P <.001). VUME was preferred by 83% of subjects. CONCLUSION: VUME is a diagnostic alternative to the Q-Tip test for the assessment of urethral hypermobility and is preferred by subjects.

Original languageEnglish (US)
Pages (from-to)528.e1-528.e6
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Jun 2012


  • Q-tip test
  • stress urinary incontinence
  • urethral hypermobility
  • visual urethral mobility examination

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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