The Comparison of the Abdominal Leak Point Pressure and the 1-Hour Pad Test in Patients with Stress Urinary Incontinence

Abstract

Purpose: The aim of this study was to determine whether or not the 1-hour pad test demonstrates the objective severity of female stress urinary incontinence. Materials and Methods: One hundred eighteen female patients with stress urinary incontinence symptom were prospectively evaluated with a 1-hour pad test as recommended by the International Continent Society and they also underwent videourodynamics to determine the ALPP. The patients were divided into 2 groups by the ALPP: group A (n=94) was the low leak point pressure group (ALPP≤100cmH2O), and group B (n=24) was the high leak point pressure group (ALPP>100cmH2O or no leakage). A pad gain ≤2g was considered a negative pad test. Student's t-test was done to evaluate the difference of urine leakage between the two groups. Results: The mean amount of urine leakage measured by the 1-hour pad test for groups A and B were 53.4±47.2 and 50.9±53.9g, respectively, and there was no statistically significant differences between two groups (p= 0.839). Eighteen (15.2%) women did not leak during the ALPP measurement and 6 (5.1%) women had a negative pad test. Among the 18 women with no leakage on the ALPP, 15 had a positive pad test and 3 had a negative pad test. Among the 6 women with a negative pad test, 3 had leakage and 3 had no leakage during the ALPP measurement. One hundred fifteen patients received an operation for stress urinary incontinence. The three patients who had no leak on the ALPP and who also had a negative pad test did not receive the operation. Conclusions: These data suggest that the 1-hour pad test did not demonstrate the objective severity of stress urinary incontinence. However, the 1-hour pad test was more sensitive to demonstrate leakage than the ALPP; therefore, in the case of no leakage during the ALPP measurement, the 1-hour pad test is needed to check the leakage. (Korean J Urol 2006;47: 847-851)