BERKELEY, CA (UroToday Inc.) - The 1-hour pad test has been used as an objective tool in studying women with urinary incontinence (UI). It has been considered essential as an outcome measurement for treatments of stress urinary incontinence so that results of studies can be compared. Although the test is reasonably simple to administer, it can still be time and resource consuming. How well a simple self-assessment of UI correlates with pad tests and quality of life (QOL) is not clear.

Abdel-fattah and colleagues from the United Kingdom performed a prospective cohort to study the correlation between subjective self-assessment, pad test, and QOL. Subjects were recruited from a group of women who were undergoing surgical treatment for "urodynamic stress incontinence" of urine. Ninety women participated. All had preoperative standardized 1-hour pad tests and 70 repeated the test four months postoperatively. All were asked to classify themselves on a graded scale as being totally continent (0), or having mild (1), moderate (2), or severe (3) UI. They also measured QOL by completing the King's Health Questionnaire (KHQ).

They analyzed their data and reported it in the September edition of European Urology. 97.3% of women with subjective UI had a positive 1-hour pad test (>1 gram gain), while 89.3% of women with subjective continence had a negative pad test. The self assessed severity of UI correlated poorly with the amount of pad gain. Self-assessment groups correlated more closely with the KHQ than did the amount of pad gain.

In conclusion, the strong correlations between self-assessment of incontinence or continence with a positive or negative pad test and the severity of UI with the KHQ makes self-assessment of UI a simpler and more cost effective instrument in the evaluation of UI than the 1-hour pad test.

Eur Urol 2004; 46:377-380