Office screening test for intrinsic urethral sphincter deficiency: Pediatric Foley catheter test

Objective: To evaluate an office-based test as a screening method for intri nsic sphincter deficiency. Methods: One hundred seventy-three women with urinary incontinence were eva luated prospectively by complete urodynamic studies. After catheterization, the pediatric Foley catheter test was performed on an empty bladder by wit hdrawing the inflated bulb of an 8-French Foley catheter through the urethr a. The test was considered positive if the inflated catheter bulb could be withdrawn completely through the urethra. Women with grade 3 genital prolap se or higher were excluded. Intrinsic sphincter deficiency was defined as t he presence of genuine stress incontinence and low maximum urethral closure pressure (at most 20 cm H2O). Results: Seventy-six of 173 women (44%) had positive tests and 97 (56%) had negative tests. Seventy-six percent of those with positive tests were diag nosed with intrinsic sphincter deficiency, compared with 19% in women with negative tests (P < .001). All women with positive tests and negative cotto n swab tests had intrinsic sphincter deficiency. The sensitivity, specifici ty, and positive and negative predictive values for diagnosing intrinsic sp hincter deficiency were 76, 81, 76, and 81%, respectively. Conclusion: A positive pediatric Foley catheter test in the absence of uret hral mobility strongly suggests intrinsic sphincter deficiency. The pediatr ic Foley catheter test may be useful in screening for intrinsic sphincter d eficiency. (Obstet Gynecol 2001;97:885-9. (C) 2001 by The American College of Obstetricians and Gynecologists.).