Twenty-three normal volunteers and 31 women admitted for stress or mixed incontinence underwent two 24-hour home pad weighing tests. In the patients the test result was compared with the result obtained with the 1-hour ward pad weighing test. Median pad weight gain was 4 g/24-h, with an upper 99% limit of 8 g/24 h in normal women. The median urine loss was 17 g/24-h in the patients. Eighteen (58%) patients were classified as incontinent according to the result of the 1-h ward test, versus 28 (90%) according to the result of the 24-h home test. There was no significant correlation between the result of the 1-h test and the 24-h test. In the patients, test-retest analysis showed a significant variation in the result of the 24-h test. It is concluded that the better of two 24-h home tests is more sensitive for confirmation incontinence than is one 1-h ward test. Consequently, the 24-h home test is of practical use as a screening test for incontinence. The reproducibility of the test, however, seems insufficiently satisfactory to allow of its use in comparative scientific studies.
Vaginal repair has been recommended in cases of stress urinary incontinence and posterior bladder suspension defect diagnosed by colpocysto-urethrography. Thirty-eight women with stress urinary incontinence and posterior suspension defect have been treated. First, 19 women underwent a vaginal repair. In a second period, another 19 consecutive patients had a colposuspension a.m. Burch. The patients have been evaluated 6 months postoperatively and at a long-term follow-up. No significant difference was found postoperatively in the frequency of symptoms and signs of stress incontinence, either after 6 months or at the long-term follow-up. A significantly smaller frequency of genital prolapse was found in the colposuspension group at long-term follow-up. No side effects such as frequency, urgency or bacteriuria were evident in the group treated by colposuspension. With reservation to the non-randomized allocation, it may be concluded that a radiographic distinction between anterior and posterior bladder suspension defects in choosing the surgical approach is unnecessary.
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