Comparison of the cough stress test and 24-h pad test in the assessment of stress urinary incontinence

Introduction and hypothesis The 24-h pad test and cough stress test are commonly used to assess stress urinary incontinence; however, no comparative data are available. The cough stress test is superior to the 24-h pad test. Methods Women with predominant stress urinary incontinence symptoms underwent a cough stress test, a 24-h pad test, and urodynamic testing. Results Complete data were available on 55 women. Agreement between the urodynamic results and the stress test occurred in 89% of women (k=0.51). Sensitivity, specificity, and positive and negative predictive values were 90%, 80%, 98%, and 44%. Agreement between the urodynamic results and the pad test occurred in 60% of women (k=0.08). Sensitivity, specificity, and positive and negative predictive values were 60%, 60%, 94%, and 13%. Agreement between the cough stress test and the pad test occurred in 67% (k=0.26). Conclusions The cough stress test is more reliable than the pad test for documentation of stress urinary incontinence.