Urinary Pad Test Shows Promise for Use in Young Women

BARCELONA—A new urinary pad test designed to assess urine leakage in young, healthy women with stress urinary incontinence (SUI) is showing early favorable results, a team  from the University of Saskatchewan in Saskatoon reported at the 43rd Annual Meeting of the International Continence Society.

Juliet Sarjeant, an MSc student in physical therapy, and her research supervisor Stephanie Madill, PhD, Assistant Professor of Physical Therapy, evaluated the new test in 13 nulliparous women aged 22 to 29 years who had a mean body mass index (BMI) of 21.69 kg/m2 whom they had recruited through advertising at a local university campus.

Overall, from 7% to 14% of young, healthy women have SUI according to current reports in the literature, with the incidence increasing to 19% to 31% in the military population and up to 49% in college-age athletes.  

Pad tests described to date have only been evaluated in older, parous women. Additionally, these same investigators found that they are not sufficiently provocative to elicit urine loss in the young, nulliparous population with SUI. 

Women who volunteered for the present study were asked to drink a liter of water and not to empty their bladder until they had completed the pad test. Afterwards, they ran up and down 40 steps twice and then performed a series of exercises followed by 10 hard coughs. The entire test took about 10 minutes to complete.

Study participants were instructed not to try to prevent leakage during testing by slowing down or stopping activities or squeezing their pelvic floor muscles.

All women wore a pad during the test. Seven of them were continent, and six had SUI.

The mean increase in pad weight following the test was 0.64 g for the continent group and 9.92 g for the SUI group.

The finding that the increase in pad weight in the continent women did not exceed 1 g implies that the experimental pad test does not promote quantifiable vaginal secretions or perspiration, the researchers noted. In addition, it suggests that any gain in pad weight larger than 1 g is evidence of incontinence.  

The test was not able to provoke quantifiable urine loss in two women with SUI, resulting in two false-negative results. However, the investigators emphasized that the two false-negatives do not necessarily indicate that the women had no leakage whatsoever but rather that their leakage was less than 1 g—an amount that may nonetheless be bothersome. Accordingly, they said that more research is needed to develop methods for measuring small amounts of leakage.

Further analysis showed that the pad test provoked similar amounts of urine loss on two consecutive testing days, thereby suggesting that the test may be used to examine temporal fluctuations in SUI symptoms. 

The authors said that advantages of the pad test are that it is quick to administer (approximately 10 minutes) and does not require any specialized equipment or training to administer, which makes it easy to “transfer” to the clinical setting. 

Importantly, the study included both women with and without SUI and the test was able to discriminate between the two groups.

Finally, the study is limited by its small sample size, they said.  Also, although the women followed a standardized fluid consumption protocol, the researchers did not confirm that the volume of urine in women's bladders was similar, both among the participants and between the testing days.

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