Pad tests and self-reports of continence in men awaiting radical prostatectomy: establishing baseline norms for males.

Abstract

In this study, we report normal pad weight gain in a group self-reported continent men and compare the self-report data with the 24-hr pad test and the International Prostate Symptom Score (IPSS). Subjects awaiting radical prostatectomy were consecutively recruited. Exclusion criteria were a previous history of urologic surgery, reported urinary incontinence, or a medical problem which could affect bladder function. Two hundred forty five men were enrolled. All were Caucasian, mean age 62.7 years, mean Gleason score 6.5, and mean PSA 8.3. At initial interview, all described themselves as continent of urine and 26 declined the 24-hr pad test because they were emphatic that they were continent. Of the 220 remaining, mean pad weight gain was 4.0 g on 24-hr pad test (SD 3.8; range 0-35.0 g), mean IPSS score was 7.23; 95 subjects scored > or = 8 (moderate), 13 scored > or = 20 (severe). The IPSS single Quality of Life (QOL) question and the 24 hr pad weight were not correlated; the summary IPSS score and pad weight had a correlation of 0.16 (P = 0.02) and the QOL question and the summary IPSS score had a correlation of 0.63 (P < 0.001). IPSS QOL scores were worse for those recording > or = 8 (P < 0.001). The range of weight gain between 0 and 35 g suggests that self-report alone of urinary continence is an inaccurate measure of continence for research purposes. We propose that a pad weight gain of 8 g or less is indicative of urinary continence in men.