Is the Cough Stress Test Equivalent to the 24 Hour Pad Test in the Assessment of Stress Incontinence?

The 24 hour pad test involves women collecting their pre-weighed incontinence pads for 24
hours and returning them to the clinician for weighing. This allows for accurate
quantification of urine loss. This test is often used in clinical studies before and after
intervention to assess efficacy of treatment.

The cough stress test is an alternative testing modality used to evaluate stress
incontinence. It is an easy test to perform in a single visit to the clinician's office and
the results are immediately available. It involves the patient coughing forcefully with a
full bladder and watching for leakage of urine through the urethra.

In our study, our primary aim is to compare the equivalency of the cough stress test to the
24 hour pad test as a measure of stress urinary incontinence. Our secondary aim will be to
assess patient comfort and satisfaction with each of the testing modalities. If the cough
stress test is equivalent, it will provide an additional, easy to use tool for patient
evaluation.

Inclusion Criteria:

- patients with the primary complaint of stress incontinence with minimal or no urge
incontinence symptoms. They must be able to read English as the study involves use
of validated questionnaires which have only been validated in English.

Exclusion Criteria:

- patients unable to stand (to perform standing stress test), patients with leakage
from a urinary tract fistula, use of vaginal creams within 72 hours of the pad test,
active vaginal infection, sexual intercourse within 24 hours of the pad test and
patients who do not read English.