557 HOW WELL PATIENT PERCEPTION OF PAD USE CORRELATES WITH THE DEGREE OF INCONTINENCE IN POST PROSTATECTOMY INCONTINENCE: THE SUFU PAD TEST STUDY

Abstract

INTRODUCTION AND OBJECTIVES: The severity of post prostatectomy incontinence (PPI) often influences treatment and is best accessed by a 24-hour pad test (24PT) weight (wt). Many used # pads to determine severity of PPI, yet the accuracy of this is unproven. Our aim was to determine if patient’s perception of pad use and urine loss measured by questionnaires, reflects actual urine loss measured by 24PT. Further, we sought to determine if pad size and degree of wetness, as well as other quality of life (Qol) measures, improved the correlation with actual urine loss. METHODS: We prospectively enrolled men 6 m after prostatectomy, with incontinence, requiring daily protection. Patients were given questionnaires asking about the following variables: # pads, size of pads, and wetness of pads. They were asked a Qol question (“To what extent does urine loss affect your Qol?”). Men completed a 24PT using their own pads. The actual # of pads used, pad size, and net wt was determined. Patients completed UDI-6, IIQ-7, UCLA/RAND, IPSS. SPSS was used for statistical testing. RESULTS: 235 men from 18 sites with a mean age of 65.9 had a mean 24PT wt of 304 gm. Perception of # of pads worn was in close agreement with actual # used (table 1). Perceived and actual pad size had excellent concordance (76%, p 0.001). Both perceived and actual pad # had a strong positive relationship with 24PT wt. Patients that had perceived wetness of “wet” and “soaked” had pad wt significantly different from each other, and from the “almost dry” and “slightly wet” groups. Only the single item impact on Qol separated men into 4 significantly different groups based on mean 24PT wt (figure 1); all remaining incontinence questionnaires had weak correlations. CONCLUSIONS: Men with PPI accurately describe the # and size of pads collected during 24PT. The single question on QoL separated men into distinct categories. 24PT wt is currently the most reliable test of degree of PPI, but in most cases the needed information obtained is ascertained by simple questions pertaining to pad use, pad size and degree of wetness.