Inadequate repeatability of the one-hour pad test: the need for a new incontinence outcome measure

Simons, Andrew M.; Yoong, Wai; Buckland, S; Moore, Kate H.

doi:10.1016/s0306-5456(00)00069-3

Cited by 35 publications

(32 citation statements)

References 9 publications

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“…The 1-hr pad test has the signi¢cant advantages of requiring no advance Neurourology and Urodynamics DOI 10.1002/nau planning and providing rapid results. However, the outcome is extremely dependent on the initial conditions of the test, and the reliability of the test has been repeatedly called into question [Lose et al, 1988;Ryhammer et al, 1999;Simons et al, 2001]. The 24-hr pad test has been shown to produce reliable results that correlate well with pad testing carried out over a longer period [Groutz et al, 2000;Karantanis et al, 2005].…”

Section: Discussionmentioning

confidence: 99%

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

Dylewski

Jamison

Borawski

et al. 2006

Neurourology and Urodynamics

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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.

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Section: Discussionmentioning

confidence: 99%

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

Dylewski

Jamison

Borawski

et al. 2006

Neurourology and Urodynamics

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“…Previous authors found a relationship between 1-hour pad test weight and MCC at urodynamics [7,26] . We cannot confirm these data because although our patients performed the same provocation exercises during the test, they did not perform the test at a fixed bladder volume and did not keep a voiding diary.…”

Section: Discussionmentioning

confidence: 85%

“…Even though the pad was heavier in stress incontinence, a positive or negative test result was not associated with incontinence type. In women with similar bladder volumes, Simons et al [7] found the testretest reliability of the 1-hour pad test clinically inadequate, and 44% of women who were wet at the 1-hour pad test had no episodes of incontinence [20] .…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and Specificity of One-Hour Pad Test as a Predictive Value for Female Urinary Incontinence

et al. 2008

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Aim: To analyze the sensitivity and specificity of the 1-hour pad test, as suggested by the International Continence Society, in the diagnosis of female urinary incontinence. Methods: 158 female patients, with or without urinary incontinence, underwent a 1-hour pad test. The pad test was assessed as positive or negative and pad weight was recorded. Uni- and multivariate analysis investigated correlation with age, body mass index (BMI), symptoms, prolapse grade, urinary incontinence grade and type, number of pads daily, urodynamic variables and Urogenital Distress Inventory and Incontinence Impact Quality of Life questionnaires. Results: A positive 1-hour pad test was significantly associated with urinary incontinence grade, with a positive stress test, with detrusor overactivity (DO), urine leakage and a positive Valsalva leak point pressure at urodynamics. The association between presence/absence of incontinence and DO, stress test, urine leakage and pad weight had 83% sensitivity and 89% specificity in predicting urinary incontinence. When the 1-hour pad test result was added to stress test and urine leakage versus presence/absence of incontinence, the sensitivity was 90%, and specificity 65%. Conclusions: Our data seem to confirm the 1-hour pad test has poor predictive value in the diagnosis of female urinary incontinence when associated to stress test and urine leakage.

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“…We have used the 1-h pad test as recommended by the International Continence Society [17]. However, a number of studies have reported poor reproducibility for the 1-and 24-h pad test [24][25][26][27]. In a study by Simons et al, the test-retest reliability of the 1-h pad test was shown to be inadequate, with the first and second tests differing by −44 to +66 g, despite the women having similar bladder volumes [27].…”

Section: Discussionmentioning

confidence: 99%

Effects of Macroplastique® Implantation System for stress urinary incontinence and urethral hypermobility in women

et al. 2008

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A study was carried out to evaluate efficacy of Macroplastique® (MPQ) Implantation System (MIS) in women with urodynamic stress urinary incontinence (SUI) and urethral hypermobility after an unsuccessful conservative treatment. This is a prospective randomized controlled trial in women without previous incontinence surgery. Twenty-four women received MPQ. Twenty-one controls underwent a pelvic floor muscle exercises home program. Follow-up was at 3 months and the MPQ group also at 12 months. At 3 months, pad usage decreased significantly more in the MPQ group than in the control group (p= 0.015). According to physician and patient self-assessment, respectively, 71% and 63% women in the MPQ group were considered cured or markedly improved. This was significantly higher compared to controls. There was a significant higher increase of Incontinence Quality-of-Life questionnaire score in the MPQ group compared to controls (p= 0.017). Improvements in MPQ group at 3 months are sustained to 12 months. Adverse events were mild and transient. MIS is an acceptable option for women with SUI and urethral hypermobility.

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Inadequate repeatability of the one-hour pad test: the need for a new incontinence outcome measure

Cited by 35 publications

References 9 publications

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

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

Sensitivity and Specificity of One-Hour Pad Test as a Predictive Value for Female Urinary Incontinence

Effects of Macroplastique® Implantation System for stress urinary incontinence and urethral hypermobility in women

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