Cotton swab test

The cotton swab test is an auxiliary test method for checking whether the urination function is normal. When the abdominal muscles of normal people relax, the bladder neck is at the lower edge of the bladder. It is located at the junction of the lower third of the pubic symphysis. When the abdominal pressure is increased, it moves down 0.5cm-1.5cm. The bladder neck is not at the lower edge of the bladder and moves up. In patients with stress urinary incontinence, the bladder neck is lower than the normal position when the abdominal wall is relaxed, and the position of the bladder neck changes when the abdominal pressure increases. If the bladder neck is moved down, the posterior horn of the urethra disappears. When the abdominal pressure increases, the bladder neck moves more obviously, which can be >1.5cm, which causes the urinary tract to change. Thus, determining the angle of the urethra can determine whether the anatomical relationship of the bladder is normal. After the posterior horn of the urethra disappears, when the abdominal pressure increases, the urethral sphincter is pulled open by the bladder wall, leading to urinary incontinence. Basic Information Specialist classification: urinary examination classification: other examinations Applicable gender: whether women are fasting: not fasting Tips: Maintain a normal diet and sleep. Normal value When the normal female abdominal wall is relaxed, the angle between the cotton swab and the horizontal line is about -5 degrees - +10 degrees. After holding the breath, the cotton swab maintains the original position, indicating that the urethra and bladder anatomy are normal. Clinical significance Abnormal results: 1. When the normal female abdominal wall is relaxed, the angle between the cotton swab and the horizontal line is about -5 degrees - +10 degrees. 2. After holding the breath, the cotton swab maintains the original position, indicating that the urethra and bladder anatomy are normal. 3. After the breath holding, the exposed part of the cotton swab is 10 degrees higher than the original, indicating that the posterior horn of the urethra has disappeared, but there is no urethral drooping. 4. After holding the breath, the cotton swab is up to 20 degrees above the original, indicating that the urethra has been displaced downwards and backwards. 5. After the breath holding, the angle between the cotton swab and the horizontal line is >45 degrees, indicating that the urethral support tissue has been severely weakened, and the posterior urethra is drooping significantly. The greater the angle, the more severe the degree of posterior urethral sag. People who need to be examined: Identification of the cause of female urinary incontinence. Precautions Taboo before check: Maintain normal diet and sleep. Requirements for inspection: 1. The cotton swab should be smooth and not too strong when inserted to prevent damage to the urethra. 2. The length of the cotton swab is about 10cm, it is difficult to measure the angle too short, and the exposed part can be drooped by its own gravity. Inspection process 1. The patient takes the bladder lithotomy position and disinfects the vulva. 2. Take a smooth and sterilized long cotton swab, place the local anesthetic (tetracaine or lidocaine), gently insert it into the urethra about 4cm, and observe the angle between the exposed part and the horizontal line. 3. The patient is forced to hold the breath to increase the abdominal pressure, and then observe the angle between the exposed part of the cotton swab and the horizontal line, and compare with the breath before the breath. Not suitable for the crowd Inappropriate people: those with urinary tract infections. Adverse reactions and risks No related complications or hazards.

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