title: Objective assessment of urinary incontinence in women: comparison of the one-hour and 24-hour pad tests.
abstract: OBJECTIVE
  To compare the performance and clinical usefulness of the one-hour and 24-hour pad tests in terms of the relationship with reported symptoms and urodynamic diagnosis.
  
  
  METHODS
  341 women aged 40 years and over reporting lower urinary tract symptoms who were recruited to a nurse led continence service, and went on to receive urodynamics, a one-hour and a 24-hour pad test and completed a urinary diary.
  
  
  RESULTS
  For both pad tests, there was a significant difference in the amount of urine leaked between the different urodynamic diagnoses (p<0.0001, for the one-hour and p=0.001 for the 24-hour test). Women with sphincter incompetence leaked significantly more than women with detrusor instability, or those with no abnormality. There was a significant difference between the proportion of women dry on a one-hour pad test and those dry on a 24-hour pad test (26.0% versus 38.4%, difference 12.4%; CI 5.5; 19.4). There is a positive relationship between amount of urine leakage and symptom severity expressed in terms of number of incontinent episodes for both pad tests.
  
  
  CONCLUSIONS
  Both pad tests bore little relationship to the underlying urodynamic diagnosis but there was a positive relationship with symptom severity. The 24-hour pad test appears to be clinically a more useful too than the one-hour test. The two types of pad test are probably assessing incontinence in different ways. We suggest that the minimum data set should include structured questions, diaries and the 24-hour pad test.
authors.affiliation: Department of Obstetrics and Gynecology, Leicester General Hospital, Gwendolen Road, LE5 4PW Leicester, UK. gm56@le.ac.uk
authors.forename: Gurminder S
authors.initials: GS
authors.lastname: Matharu
authors.forename: R Philip
authors.initials: RP
authors.lastname: Assassa
authors.forename: Kate S
authors.initials: KS
authors.lastname: Williams
authors.forename: Madeleine
authors.initials: M
authors.lastname: Donaldson
authors.forename: Ruth
authors.initials: R
authors.lastname: Matthews
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Tincello
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Mayne
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016496:Incontinence Pads; D013997:Time Factors; D014549:Urinary Incontinence / Q000175:diagnosis*; D014563:Urodynamics