title: The "1-3-5 cough test": comparing the severity of urodynamic stress incontinence with severity measures of subjective perception of stress urinary incontinence.
abstract: OBJECTIVE
  The purpose of the study was to examine whether a test performed during urodynamics, the "1-3-5 cough test", could determine the severity of urodynamic stress incontinence (USI).
  
  
  METHODS
  We included women referred for urodynamics who were diagnosed with USI. The "1-3-5 cough test" was performed to grade the severity of USI at the completion of filling cystometry. A diagnosis of "severe", "moderate" or "mild" USI was given if urine leakage was observed after one, three or five consecutive coughs respectively. We examined the associations between grades of USI severity and measures of subjective perception of stress urinary incontinence (SUI): International Consultation of Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS), King's Health Questionnaire (KHQ), Urinary Distress Inventory-6 (UDI-6), Urinary Impact Questionnaire-7 (UIQ-7).
  
  
  RESULTS
  A total of 1,181 patients completed the ICIQ-FLUTS and KHQ and 612 completed the UDI-6 and UIQ-7 questionnaires. There was a statistically significant association of higher grades of USI severity with higher scores of the incontinence domain of the ICIQ-FLUTS. The scores of the UDI-6, UIQ-7 and of all KHQ domains (with the exception of general health perception and personal relationships) had statistically significant larger mean values for higher USI severity grade. Groups of higher USI severity had statistically significant associations with higher scores of most of the subjective measures of SUI.
  
  
  CONCLUSIONS
  Severity of USI, as defined by the "1-3-5 cough test", was associated with the severity of subjective measures of SUI. This test may be a useful tool for the objective interpretation of patients with SUI who undergo urodynamics.
authors.affiliation: Urogynaecology Unit, First Department of Obstetrics and Gynecology, University of Athens, "Alexandra Hospital", Lourou 1 Str, Athens, 11528, Greece. tgregos@yahoo.com.
authors.forename: Themos
authors.identifier: http://orcid.org/0000-0002-4301-8775
authors.initials: T
authors.lastname: Grigoriadis
authors.affiliation: First Department of Obstetrics and Gynecology, University of Athens, "Alexandra Hospital", Lourou 1 Str, Athens, 11528, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Giannoulis
authors.affiliation: Urogynaecology Unit, First Department of Obstetrics and Gynecology, University of Athens, "Alexandra Hospital", Lourou 1 Str, Athens, 11528, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharakis
authors.affiliation: First Department of Obstetrics and Gynecology, University of Athens, "Alexandra Hospital", Lourou 1 Str, Athens, 11528, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Protopapas
authors.affiliation: Department of Urogynaecology, King's College Hospital, Denmark Hill, London.
authors.forename: Linda
authors.initials: L
authors.lastname: Cardozo
authors.affiliation: Urogynaecology Unit, First Department of Obstetrics and Gynecology, University of Athens, "Alexandra Hospital", Lourou 1 Str, Athens, 11528, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Athanasiou
mesh_terms: D000368:Aged; D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D014550:Urinary Incontinence, Stress / Q000175:diagnosis*; D014563:Urodynamics
keywords: 1-3-5 cough test; Questionnaires; Severity grading; Stress urinary incontinence; Urodynamic stress incontinence