The Q-tip test was applied on 105 patients. Fifty-one had stress urinary 
incontinency (SUI), 28 had bladder instability by clinical and urodynamic 
criteria, and 36 had mild or moderate pelvic relaxation without urinary 
pathology. More than 90% of the patients with SUI and no previous surgery had a 
positive Q-tip test, with 90% test sensitivity in this group. More than 
one-third of the patients with bladder instability and almost one-half of the 
patients with pelvic relaxation and no urinary incontinence had a positive Q-tip 
test, for low test specificity. The Q-tip test is a simple clinical tool for 
diagnosing pelvic relaxation, which at times leads to SUI. Almost all patients 
with primary SUI have pelvic relaxation. The Q-tip test alone does not stand as 
a diagnostic test. When it is positive, the diagnosis of genuine stress 
incontinence is possible although not absolute. A negative test should cause one 
to question the diagnosis of genuine stress incontinence, and sophisticated and 
more expensive tests should be ordered before establishing a final diagnosis.