A statistical comparison of pad numbers versus pad weights in the quantification of urinary incontinence

Abstract

Aims: Pad per day (PPD) usage is a frequently utilized measure of urinary incontinence. The 24-hour pad weight test (24PWT) is a reproducible test for quantifying incontinence volumes. We investigated whether PPD validly reports the magnitude of urinary incontinence. Methods: This was a retrospective review of patients undergoing stress incontinence surgery from July 2002 to 2005. Inclusion criteria were a documented 24PWT and patient-reported PPD usage. Grams of urine loss per pad (GPP) provided a third measure of incontinence. Descriptive statistics and correlations between all variables and signi¢cance were noted. Factor analysis was performed on the three measures of leakage and age for all patients over age 50. Results: One hundred forty-¢ve male and 116 female patients met inclusion criteria. Correlated against 24PWT, GPP has the strongest association with a correlation of 0.80 for males and 0.88 for females. PPD has a weaker correlation of 0.64 for males and 0.61 for females (R 2 ¼ 0.38 overall). Factor analysis identi¢ed two components associated with incontinence. A ''leakage'' component correlated best with 24PWT and GPP. Additionally, an ''age'' component implies that despite stable 24PWT values, older patients increase GPP while PPD decreases. Conclusions: Self-reported PPD is an unreliable measure of incontinence as this variable only measures 38% of the variation of urinary incontinence volume. Patients at a given PPD level present with a wide range of 24PWT values. Older patients have higher per-pad leakage. Future incontinence studies should report 24PWT to ensure the most reliable and uniform data.

Contribution of early intensive prolonged pelvic floor exercises on urinary continence recovery after bladder neck‐sparing radical prostatectomy: Results of a prospective controlled randomized trial

“…Eastham et al 10 reported that resection of one or both bundles substantially decreases the continence rate, but this factor continues to be widely debated. 11 We chose the 24 hr Pad test because it is a useful way to quantify incontinence, superior than Pad per day usage, which is an unreliable measure of incontinence only measuring 38% of the variation of urinary incontinence volume 12 and than 1 hr Pad test which is not so sensitive in the detection of slight leakages. 13 The majority of incontinent patients complained of urine leakage during the second half of the day, commonly moving into sitting or standing.…”

Argus-T Adjustable Male Sling: The Influence of Surgical Technique on Complications and Short-Term Efficacy

“…Dylewski et al [10] also showed that the correlation of grams urine loss per day versus actual pads per day is poor. Moreover, Wallerstedt et al [11] demonstrated that patients using only a safety pad had 5 times higher risk of bother than those using no pads after radical prostatectomy.…”

Pelvic floor muscle function is an independent predictor of outcome after retrourethral transobturator male sling procedure

“…Larger differences occurred in patients who suffered from moderate PSUI (12.1 vs. 25.9 %). Pads usage is a simple tool routinely used in the clinical practice, but its objective measurement of PSUI severity might be limited by differences of patients' daily physical activity [24,25]. In addition, PSUI severity was assessed by 1-h pad test.…”