Skip to main content
Log in

Pad-weighing tests in the diagnosis and quantification of incontinence

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Pad tests for assessing urinary incontinence have existed for over 20 years, but have recently been subject to scientific scrutiny. Essentially there are two types of tests, those carried out in the laboratory or office and those done at home. The principal issues are those of accuracy and validity, the latter usually being a question of reproducibility. The laboratory tests last for 1 or 2 hours, have precisely defined exercise regimens and documented normal loss rates of less than 2 g/h. For the tests where bladder volume is regulated, reproducibility is better but the tests are more invasive. These office tests have a high predictive value positive but do suffer from an excessive false negative rate. Home pad tests, on the other hand are less regulated, last for 24 or 48 hours and have normal loss rates of less than 8 g/24 h. They have a better predictive value negative and an equivalent predictive value positive and so are probably superior in terms of their reproducibility. Pad tests have their limitations but should be regarded as a valuable component of the urodynamic armamentarium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bates P, Bradley WE, Glen E, Melchior H, Rowan D, Sterling A, Hald T. First report on the standardization of terminology of lower urinary tract function. Br J Urol 1976; 48:39–42

    Google Scholar 

  2. Caldwell KPS, Cook PJ, Falck FC, James D. Treatment of postprostatectomy incontinence by electronic implant. Br J Urol 1968; 40:183–186

    Google Scholar 

  3. Caldwell KPS. Clinical use of recording nappy. Urol Int 1974; 29:172–173

    Google Scholar 

  4. James ED, Falk FC, Caldwell KPS, Martin MR. Continuous measurement of urine loss and frequency in incontinent patients. Br J Urol 1971; 43:233–237

    Google Scholar 

  5. Sutherst J, Brown M, Shawer M. Assessing the severity of urinary incontinence in women by weighing perineal pads. Lancet 1981; I:1128–1130

    Google Scholar 

  6. Walsh JB, Mills GL. Measurement of urinary loss in elderly incontinent patients. A simple and accurate method. Lancet 1981; I:1130–1131

    Google Scholar 

  7. Bates P, et al. Fifth report on the standardization of terminology of lower urinary tract function. Bristol: International Continence Society Committee on Standardisation of Terminology, 1987

    Google Scholar 

  8. Armitage P. Statistical methods in medical research. Oxford, Blackwell Scientific Publications, 1971; 433–438

    Google Scholar 

  9. Versi E, Cardozo L, Anand D. The use of pad tests in the investigation of female urinary incontinence. J Obstet Gynaecol 1988; 8:270–273

    Google Scholar 

  10. Versi E, Cardozo LD. Perineal pad weighing versus videographic analysis in genuine stress incontinence. Br J Obstet Gynaecol 1986; 93:364–366

    Google Scholar 

  11. Klarskov P, Hald T. Reproducibility and reliability of urinary incontinence assessment with a 60-min test. Scand J Urol Nephrol 1984; 18:293–298

    Google Scholar 

  12. Lose G, Gammelgaard J, Jørgensen TJ. The one-hour padweighing test: reproducibility and the correlation between the test result, the start volume in the bladder and the diuresis. Neurourol Urodyn 1986; 5:17–21

    Google Scholar 

  13. Jørgensen L, Lose G, Andersen JT. One-hour pad-weighing test for objective assessment of female urinary incontinence. Obstet Gynecol 1987; 69:39–42

    Google Scholar 

  14. Lose G, Rosenkilde P, Gammelgaard J, Schroeder T. Pad weighing test performed with a standardized bladder volume. Urology 1988; 32:78–80

    Google Scholar 

  15. Lose G, Jørgensen L, Thunedborg, P. 24-hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence. Acta Obstet Gynecol Scand 1989; 68:211–215

    Google Scholar 

  16. Mouritsen L, Berild G, Hertz J. Comparison of different methods for quantification of urinary leakage in incontinent women. Neurourol Urodyn 1989; 8:579–587

    Google Scholar 

  17. Versi E, Orrego G, Hardy E. Should videocystourethrography remain as the gold standard. Neurourol Urodyn 1990; 9:324–325

    Google Scholar 

  18. Victor A, Larsson G, Åsbrink A-S. A simple patient administered test for objective quantitation of the symptom of urinary incontinence. Scand J Urol Nephrol 1987; 21:277–279

    Google Scholar 

  19. Eadie AS, Glen ES, Rowan D. Assessment of urinary loss over a two-hour test period: a comparison between the Urilos recording nappy system and the weighed perineal pad method. Proceedings of the 14th Annual Meeting, International Continence Society, Innsbruck 1984, pp. 94–95

    Google Scholar 

  20. Jørgensen L, Steen A, Bagger PV, Fischer-Rasmussen W. The one-hour pad-weighing test for assessment of the result of female incontinence surgery. Proceedings of the 15th Annual Meeting, International Continence Society, London 1985, pp. 392–393

    Google Scholar 

  21. Mundt-Petterssen B, Matthiasson A, Sundin T. Reproducibility of the 1-hour incontinence test proposed by the ICS standardization committee. Proceedings of the 14th Annual Meeting, International Continence Society, Innsbruck 1984; pp. 90–91

    Google Scholar 

  22. Fantl JA, Harkins SW, Wyman JF, Choi SC, Taylor JR. Fluid loss quantitation test in women with urinary incontinence: a testretest analysis. Obstet Gynecol 1987; 70:739–743

    Google Scholar 

  23. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; I:307–310

    Google Scholar 

  24. Kinn A-C, Larsson B, Nielsson E. Pad test in urinary stress incontinence — standardization and reliability. Scand J Urol Nephrol (Suppl. 101, p 15) 1986:20

    Google Scholar 

  25. Kromann-Andersen B, Jakobsen H, Andersen JT. Pad-weighing tests: a literature survey on test accuracy and reproducibility. Neurourol Urodyn 1989; 8:237–242

    Google Scholar 

  26. Jacobsen H, Vedel P, Andersen JT. Objective assessment of urinary incontinence. An evaluation of three different padweighing tests. Neurourol Urodyn 1987; 6:325–330

    Google Scholar 

  27. Klevmark B, Talseth T, Eri LM. Objective assessment of urinary incontinence. The advantage of relating 24 hours pad-weighing test frequency-volume chart (‘combined test’). Neurourol Urodyn 1988; 7:170–171

    Google Scholar 

  28. Hald T. Quantitation of urine loss. Neurourol Urodyn 1989; 6:543–544

    Google Scholar 

  29. Lose G, Thind P, Colstrup H, Jørgensen TJ. Psychosocial distress of urinary incontinence and its relation to the standardized pad weighing test. Neurourol Urodyn 1990; 9:164–165

    Google Scholar 

  30. Holm-Bentzen M, Klarskov P, Opsomer R, Maegaard EM, Hald T. Objective assessment of urinary incontinence after successful implantation of the AMS artificial urethral sphincter. Neurourol Urodyn 1985; 4:9–13

    Google Scholar 

  31. Frazer MI, Haylen BT, Sutherst JR. The severity of urinary incontinence in women. Comparison of subjective and objective tests. Br J Urol 1989; 63:14–15

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lose, G., Versi, E. Pad-weighing tests in the diagnosis and quantification of incontinence. Int Urogynecol J 3, 324–328 (1992). https://doi.org/10.1007/BF00499653

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00499653

Keywords

Navigation