The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence.
OBJECTIVE
We assessed the relationships among severity measures of urinary incontinence in women with stress predominant symptoms enrolled in a randomized clinical trial comparing 2 surgical techniques (Burch colposuspension vs pubovaginal sling) for stress urinary incontinence.


METHODS
A total of 655 women underwent a standardized preoperative assessment that included the Medical, Epidemiological and Social Aspects of Aging questionnaire, Urogenital Distress Inventory, Incontinence Impact Questionnaire, 3-day voiding diary, 24-hour pad test, a supine empty bladder stress test and Valsalva leak point pressure measurements. Correlations were estimated using Spearman correlation coefficients and 95% confidence intervals. T tests at alpha=0.05 were conducted to compare the distributions of the continuous severity measure between patients with positive and negative supine empty bladder stress test.


RESULTS
Baseline mean scores on Medical, Epidemiological and Social Aspects of Aging, Urogenital Distress Inventory and Incontinence Impact Questionnaire were 25.8, 151 and 171, respectively. Mean incontinence episode frequency and pad weight were 3.2 per day and 43.5 gm, respectively. Supine empty bladder stress test was positive in 218 patients, and 428 patients had valid Valsalva leak point pressure measurements with a mean Valsalva leak point pressure of 80 cm H(2)O. Weak to moderate correlations were observed between Medical, Epidemiological and Social Aspects of Aging, incontinence episode frequency, pad weight, Incontinence Impact Questionnaire and Urogenital Distress Inventory. On the other hand, Valsalva leak point pressure correlated poorly with all variables measured. The sensitivity and specificity of the supine empty bladder stress test to predict intrinsic sphincter dysfunction were 49% and 60%, respectively.


CONCLUSIONS
Urinary incontinence severity measures correlate moderately with each other at best. While Medical, Epidemiological and Social Aspects of Aging demonstrated stronger correlations with the other measures of severity and quality of life, Valsalva leak point pressure did not. Supine empty bladder stress test did not demonstrate a clinically significant association among severity measures.
Albo
Michael
M
Division of Urology, University of California, San Diego, California 92103-8897, USA. malbo@ucsd.edu
Wruck
Lisa
L
Baker
Jan
J
Brubaker
Linda
L
Chai
Toby
T
Dandreo
Kimberly J
KJ
Diokno
Ananias
A
Goode
Patricia
P
Kraus
Stephen
S
Kusek
John W
JW
Lemack
Gary
G
Lowder
Jerry
J
Steers
William
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D019919:Prosthesis Implantation / Q000295:instrumentation*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016683:Supine Position; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014636:Valsalva Maneuver / Q000502:physiology*