Strong correlation between standing cough test and 24‐hour pad weights in the evaluation of male stress urinary incontinence

Yi, Ya Sha; Keith, Christopher G.; Graziano, Christopher; Davenport, M.; Bergeson, Rachel; Christine, Brian; Morey, Allen F.

doi:10.1002/nau.24200

Cited by 17 publications

(21 citation statements)

References 17 publications

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“…In follow-up exams, a urological examination was performed to rule out mesh complications at the suburethral level and the presence of SUI through the stress test [ 22 ]. Patients were given ICIQ-SF [ 18 ], quality of life SF-36 [ 20 ], and visual analog scale (VAS) questionnaires [ 13 ] in post-intervention controls at months 1, 6, and 12, and annually.…”

Section: Methodsmentioning

confidence: 99%

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Cisneros-Pérez

Yusta-Martín

Sánchez-Conde

et al. 2020

JCM

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Introduction: Stress urinary incontinence (SUI) has an incidence of 15–80% in women. One of the most widely used surgical techniques for treatment is the placement of a suburethral transobturator tape (TOT). Although this technique has a relatively low morbidity rate, it is not exempt from intraoperative or postoperative complications, which can have an impact on functional recovery, understood as the return to routine life prior to the intervention. Aims: To assess the time for functional recovery in women operated on for SUI by TOT; to identify complications and related factors, according to anaesthetic risk, which condition the time to functional recovery; and proposals for improvements in the prevention of possible complications and in reducing functional recovery time. Materials and methods: A non-concurrent prospective observational multicenter study of 891 women undergoing TOT for stress urinary incontinence since 1 April 2003, who were successful in achieving urinary continence (completely dry). Study groups: GA (n = 443): patients with ASA I risk. GB (n = 306): patients with ASA II risk. GC (n = 142): patients with anaesthetic risk ASA III. Investigated variables: age, body mass index, follow-up time, secondary diagnoses, surgical history, obstetric-gynecological history, toxic habits, and complications derived from surgery: bleeding, pain, infection. Descriptive statistics, Student’s t test, Chi2, Fisher, ANOVA, multivariate analysis, significance for p < 0.05. Results: Mean age was 60.10 years (SD13.38), with no difference between groups. Mean body mass index (BMI) was 26.55 kg/m2 (SD 4.51), lowest in GA. GB had more HT (38.6%) than GC (23.23%), more type 2 diabetes (19.83% versus 10.56%), and more respiratory disorders (6.97% versus 2.11%). There were more women with anxiety in GB (19.3%) than in GC (6.33%) (p = 0.0221) and GA (10.51%) (p = 0.0004). There was more hypothyroidism in GB (16.08%) compared to GC (2.11%) and GA (9.07%). There was more history of curettage in GC (11.97%) versus GB (5.63%); and more pelvic surgery in GB (71.31%) and GC (66.9%) compared to GA (32.57%). There were more concomitant treatments with benzodiazepines in GC (27.46%) and GB (28.41%) than in GA (8.86%), and more parapharmacy treatments in GB (17.96%) than in GC (6.33%). Following the operation, 113 patients had some sign or symptom that required medical attention: in GA 48 (10.83%), in GB 49 (16.06%), in GC 16 (13.22%). Mean days until functional recovery in patients with complications: in GA 5.72 (SD2.05); bleeding 3 (SD1), pain 6.40 (SD1.34), and infection 7.33 (SD0.57), with fewer days for bleeding than for pain or infection. GB: 27.96 (SD 28.42), bleeding 3 (SD0), pain 46.69 (SD31.36), infection 10.83 (SD3.90); lowest for patients with bleeding. GC: 9.44 (SD 2.50); for bleeding 7.66 (SD2. 08), pain 10.66 (SD1.15), infection 10 (SD3.46); no differences. Overall, for women with bleeding, the time was 4.16 days (SD1.94); less in GA and GB than in GC. Pain, at 31.33 days (SD 30.70), was the factor that most delayed functional recovery; in GB women, it took longer to return to work due to pain (45.96, SD31.36) compared to GA (6.4, SD 1.34) and GC (10.66, SD1.15). In women with infection, overall mean time was 10.11 days (SD 3.61) with no difference between groups. Conclusions: Mean time for the return to normal activity in patients who underwent TOT for SUI is 5 days if there are no complications, and 16.91 days if there are any. The ASA-SP risk group classification can be used to anticipate functional outcomes. An ASA-PS risk-based functional recovery forecasting protocol should be adapted, especially ASA II patients who may present with long-term disabling postoperative pain. Preventive management measures are proposed that favour functional recovery.

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Section: Methodsmentioning

confidence: 99%

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Cisneros-Pérez

Yusta-Martín

Sánchez-Conde

et al. 2020

JCM

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“…Prior studies have demonstrated that pre--operative 24-hour pad weight, PPD usage, and MSIGS scores are all predictors of sling success (5,(16)(17)(18)(19)(20)(21). PPD usage is a simple way to estimate SUI severity.…”

Section: Male Sui Assessmentmentioning

confidence: 99%

“…In 1996, Kowalcyzk and colleagues first described the SCT as a method to stratify male SUI severity to determine if one or two AUS cuffs should be used (26). We no longer perform tandem cuff AUS procedures, but we have incorporated the SCT as a method to stratify SUI severity for many years (16,17). The SCT is an easy and reproducible in-office assessment of SUI severity that provides prognostic value in the evaluation of men with moderate SUI who are considering incontinence surgery.…”

Section: Male Sui Assessmentmentioning

confidence: 99%

“…The SCT is an easy and reproducible in-office assessment of SUI severity that provides prognostic value in the evaluation of men with moderate SUI who are considering incontinence surgery. It also correlates strongly with 24-hour pad weights (17). Patients found to have unfavorable moderate SUI could then be informed of the low success rate of sling and encouraged to consider an AUS.…”

Section: Male Sui Assessmentmentioning

confidence: 99%

“…Given the emphasis on the physical exam in the 2019 AUA guidelines on surgical management of both male and female SUI (6,15), we incorporated the standing cough test (SCT) into our standard evaluation of male SUI. The SCT has been validated as a reproducible and reliable test for grading male SUI (16), and it has been shown to correlate strongly with 24-hour pad-weight (17).…”

Section: Introductionmentioning

confidence: 99%

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Standing cough test stratification of moderate male stress urinary incontinence

Khouri

Ortiz

et al. 2021

Int. braz j urol.

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Purpose: Patient-reported history of pads per day (PPD) is widely recognized as a fundamental element of decision-making for anti-incontinence procedures. We hypothesize that SUI severity is often underestimated among men with moderate SUI. We sought to compare patient history of incontinence severity versus objective in-office physical examination findings. Materials and Methods: We retrospectively reviewed our single-surgeon male SUI surgical database from 2007-2019. We excluded patients with incomplete preoperative or postoperative data and those who reported either mild or severe SUI, thus having more straightforward surgical counseling. For men reported to have moderate SUI, we determined the frequency of upgrading SUI severity by recording the results of an in-office standing cough test (SCT) using the Male Stress Incontinence Grading Scale (MSIGS). The correlation of MSIGS with sling success rate was calculated. Failure was defined as >1 PPD usage or need for additional incontinence procedure. Results: Among 233 patients with reported moderate SUI (2-3 PPD), 89 (38%) had MSIGS 3-4 on SCT, indicating severe SUI. Among patients with 2-3 PPD preoperatively, sling success rates were significantly higher for patients with MSIGS 0-2 (76/116, 64%) compared to MSIGS 3-4 (6/18, 33%) (p <0.01). Conclusions: Many men with self-reported history of moderate SUI actually present severe SUI observed on SCT. The SCT is a useful tool to stratify moderate SUI patients to more accurately predict sling success.

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Evaluation of the 24‐h pad weight test as continence rate assessment tool after artificial urinary sphincter implantation for postprostatectomy urinary incontinence: A Swedish retrospective cohort study

Brattås

Volz

Sydén

et al. 2021

Neurourology and Urodynamics

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Aim: Patient-reported pad-count as continence rate assessment tool after artificial urinary sphincter (AUS) implantation is common. However, lack of standardized continence definition using this method results in heterogeneous published efficacy outcomes. Data on 24-h pad weight tests (PWT) after primary AUS implantation for postprostatectomy urinary incontinence (PPUI) is scarce. Our aim was to evaluate the 24-h PWT as an efficacy assessment tool and correlate it to qualitative outcomes using validated questionnaires. Methods: This retrospective, single center, follow-up cohort study, evaluated 180 patients who underwent primary AUS implantation for PPUI from 2005 to 2018. Voiding diaries, 24-h PWT, validated patient satisfaction and quality of life (QoL) questionnaires were collected pre-operatively and at 3-6 months postactivation, using the institution's Electronic Medical Records. Results: The median preoperative and postoperative 24-h PWT values were 494 (interquartile range [IQR]: 304-780) and 7 (IQR: 0-25) g respectively with a significant improvement in urinary leakage of 489.5 g 99.1% (p < 0.001).Median preoperative and postoperative I-QoL results increased from 33.5 ) to 86.4 (IQR: 73.9-94.3) points, with a significant 52.9 points improvement in QoL (p < 0.001). Similarly, the median preoperative and postoperative ICIQ-SF values decreased from 20 (IQR: 17-21) to 5 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Strong correlation between standing cough test and 24‐hour pad weights in the evaluation of male stress urinary incontinence

Cited by 17 publications

References 17 publications

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Standing cough test stratification of moderate male stress urinary incontinence

Evaluation of the 24‐h pad weight test as continence rate assessment tool after artificial urinary sphincter implantation for postprostatectomy urinary incontinence: A Swedish retrospective cohort study

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