Pad weight testing in the evaluation of urinary incontinence

Aim To present the teaching module Pad Weight Testing in the Evaluation of Urinary Incontinence. This teaching module embodies a presentation, in combination with this manuscript. This manuscript serves as a scientific background review; the evidence base made available on ICS website to summarize current knowledge and recommendations. Methods This review has been prepared by a Working Group of The ICS Urodynamics Committee. The methodology used included comprehensive literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results The pad test is a non-invasive diagnostic tool for urinary incontinence. It is an easy to perform, inexpensive test with utilization in both the daily patient care and clinical research. Despite it is clear value in initial diagnosis, selection of treatment, and follow-up evaluation, only less than 10% of urologists perform the test routinely. A number of testing protocols with varying lengths of recording time exist, however, only a 1-hr pad test has been standardized. One-hour pad tests are most suitable in establishing initial diagnosis, the 24-hr test serves most often for evaluation of treatment outcomes, and longer pad tests are used in clinical studies. Conclusions The pad test is clearly underutilized. Well-designed studies providing level one evidence are lacking. Numerous variations in how the test is performed by individual urologists make the evaluation of published literature difficult. Future research goals should include randomized studies leading to establishment of optimal protocols of testing for clinical research and daily care. Neurourol. Urodynam. 33:507-510, 2014. (c) 2014 Wiley Periodicals, Inc.