Usefulness of 1-Hour Pad-Weighing Test as Preoperative Diagnostic Assessment for Female Stress Urinary Incontinence

Lee, Sung Won; Choi, Hong Yong

Abstract

PURPOSE: The 1-hour pad-weighing test was compared with the cystourethrogram as a method for the preoperative diagnostic assessment of female stress urinary incontinence.
MATERIALS AND METHODS
The records of 80 women, with stress urinary incontinence that had undergone anti-incontinence surgery, were reviewed. The 1-hour pad weighing test, proposed by the International Continence Society in 1988, was performed for the objective assessment of the degree of incontinence in all patients. History taking, physical examinations and cystourethrograms were also performed and the correlation between the 1-hour pad-weighing test and the results from the above procedures evaluated.
RESULTS
The urinary leakage was examined in all patients during the 1-hour pad-weighing test, with an average urine loss of 50g (5-150). In 13 patients, no urinary leakage was demonstrated during straining on the cystourethrogram. Thus, compared with the 1-hour pad-weighing test, the cystourethrography was less sensitive in the diagnosis of incontinence, with a 16% false negative rate. The bladder neck position and degree of descent were measured on the cystourethrogram during resting and straining. The position of the bladder neck averaged 2.2 (0.5-6.0) and 4.2cm (1.0-8.0) from the upper margin of the symphysis pubis at rest, and during straining, respectively. The difference between these two parameters averaged 2.0cm (0.2-4.0). The number of type III stress urinary incontinence patients, based on the Blaivas classification, was 9. There were statistically significant correlations between the 1-hour pad-weighing test and the bladder neck positions during resting (r=0.296, p=0.008) and straining (r=0.356, p=0.001) on the cystourethrograms. There was a statistically significant difference between the 1-hour pad-weighing test and bladder neck opening during resting (p=0.001).
CONCLUSIONS
It seems that the 1-hour pad-weighing test is an easy, inexpensive and non-invasive method for the preoperative diagnostic assessment of female stress urinary incontinence.