Functional assessment of urinary incontinence: the perineal pad test

Abstract

Perineal pad tests are simple, noninvasive functional tests which have been recommended for the evaluation of patients with urinary incontinence. Most are based on the one-hour pad test introduced by Sutherst and co-workers and standardized by the International Continence Society. The major problem with the one-hour pad test is its lack of sensitivity. Therefore a stringent test procedure was developed, whereby the limit of patient tolerance was reached. Mean end volumes of 568 ml (648 ml) immediately after the test (retest) confirmed that the patients had been examined with full bladders. Yet one in three of the incontinent patients remained dry during formal assessment. The use of the one-hour perineal pad test for clinical or research purposes should be seriously questioned.

An evaluation of a new pattern of electrical stimulation as a treatment for urinary stress incontinence: a randomized, double-blind, controlled trial

“…2) The pad test adopted was not sensitive enough to detect a change in severity of incontinence [23][24][25] or had poor compliance, whilst the frequency/volume chart had extremely poor compliance (only half the sample returned both pre and post frequency/volume charts). This last problem was not highlighted by the initial review that was conducted to determine the most suitable duration for a frequency/volume chart 26 (although more recent studies have reported similar findings 27 ).…”

“…However, it should be noted that although the one-hour pad test allowed standardization due to the use of a pre-defined protocol, this may have been at the expense of sensitivity. [22][23][24] A recent study 25 reported that although reliable, the ICS-recommended onehour pad test underestimated patients' incontinence. However, in this study the opposite was found.…”