The Standard 1-Hour Pad Test: Does It Have Any Value in Clinical Practice?

• Published in: European urology 2004-09, Vol.46 (3), p.377-380
• Main Authors: Abdel-fattah, M, Barrington, J.W, Youssef, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Diagnostic Techniques, Urological - instrumentation; Female; Humans; Incontinence Pads; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Pad test; Predictive Value of Tests; Prospective Studies; Quality of Life; Self-Assessment; Urinary incontinence; Urinary Incontinence, Stress - diagnosis; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2004.04.018

Objectives: The aim of this study was to determine whether self subjective assessment of urinary incontinence as perceived by female patients could replace the standard 1-hour pad test in clinical practice. Design: Prospective cohort study. Setting: District General Hospital, South West of England. Methods: Ninety women awaiting surgical treatment for urodynamic stress incontinence were recruited. They underwent 160 pad tests; on each test women were asked to classify themselves on a four point scale into one category (0: totally continent to urine, 1: mild/occasional urinary incontinence (UI), 2: moderate UI, 3: severe UI), to complete the King’s Health Questionnaire (KHQ) and carry out the standard International Continence Society 1-hour pad test. A pad gain >1 gm was considered a positive result. Main Outcome Measures: Women perception for severity of UI, 1-hour pad gain, KHQ scores. Results: Self subjective assessment of UI (continent vs. incontinent) had good correlation ( r=0.88) with the pad test result (negative vs. positive), and correlated well with the KHQ scores ( r=0.79). Poor correlation was seen between the pad gain and the KHQ scores ( r=0.48) and between the pad gain and the self subjective assessment of UI scale ( r=0.48). The self subjective assessment of UI (incontinent vs. continent) had sensitivity 95.65% and specificity 93.33% to detect the pad test results (positive vs. negative). Conclusion: This study suggest that, in either the pre- or postoperative phase, simply asking a woman if she is continent for urine or not was as good as doing the pad test and correlated better with the patient quality of life.