The Relationships Among Measures of Incontinence Severity in Women Undergoing Surgery for Stress Urinary Incontinence

Michael Albo, Lisa Wruck, Jan Baker, Linda Brubaker, Toby Chai, Kimberly J. Dandreo, Ananias Diokno, Patricia Goode, Stephen Kraus, John W. Kusek, Gary Lemack, Jerry Lowder, William Steers

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

Purpose: 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. Materials and 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 α = 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 H2O. 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.

Original languageEnglish (US)
Pages (from-to)1810-1814
Number of pages5
JournalJournal of Urology
Volume177
Issue number5
DOIs
StatePublished - May 1 2007

Keywords

  • female
  • quality of life
  • stress
  • urinary bladder
  • urinary incontinence
  • urodynamics

ASJC Scopus subject areas

  • Urology

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    Albo, M., Wruck, L., Baker, J., Brubaker, L., Chai, T., Dandreo, K. J., Diokno, A., Goode, P., Kraus, S., Kusek, J. W., Lemack, G., Lowder, J., & Steers, W. (2007). The Relationships Among Measures of Incontinence Severity in Women Undergoing Surgery for Stress Urinary Incontinence. Journal of Urology, 177(5), 1810-1814. https://doi.org/10.1016/j.juro.2007.01.032