Development of a pad test to assess stress urinary incontinence in young healthy women: a pilot study

Purpose: Current literature reports that between 7 and 14% of young, healthy women have stress urinary incontinence (SUI). No gold standard exists for quantifying urine leakage, although pad tests have been used in older, parous populations. The aim of this study was to determine the reliability and accuracy of a new pad test for young, healthy women with SUI. Methods: The pad test consisted of measuring quantity of leakage after the following activities: stair running, standing up from sitting, curl-ups, running on the spot, jumping jacks, jumping on a mini-trampoline and coughing vigorously. Bladder volume was standardised by having the volunteers drink one litre of water one hour prior to the testing. The volunteers performed the pad test on two consecutive days. Results: Sixteen nulliparous women between the ages of 18 and 30 years (7 controls and 9 with SUI) participated in this study. The mean increase in pad weight was 0.64 g (± 0.50) in the continent group and 11.89 g (± 20.32) in the group with SUI. There was no significant difference in pad weight between the testing sessions (p=0.228), however the test was not able to elicit measureable urine loss in 3 participants with SUI. Pad weights between the two groups of women were significantly different (p=0.023). The test re-test ICC for the continent group was 0.845 (95% CI: 0.139–0.973) and 0.782 (95% CI: -0.040–0.952) for the group with SUI. Significance: The results of this study support the use of this pad test in healthy young women with SUI; it appears to be reliable and challenging enough to cause measureable urine loss in the majority, and it may be useful for diagnosing and quantifying SUI without urodynamic studies