Noninvasive outcome measures of urinary incontinence and lower urinary tract symptoms: A multicenter study of micturition diary and pad tests

Purpose: We assessed the test-retest reliability of a 24, 48 and 72-hour mi cturition diary and pad test in patients referred for the evaluation of uri nary incontinence and lower urinary tract symptoms. Materials and Methods: We prospectively enrolled 109 patients referred for the evaluation of lower urinary tract symptoms in our multicenter study. Pa tients were requested to complete a 72-hour micturition diary and pad test, and repeat each test during a 1-week interval. The test-retest reliability of various parameters of the 72-hour micturition diary and pad test was an alyzed and compared. Further analysis was done to compare the test-retest r eliability of 24, 48 and 72-hour studies performed on the same days after a 1-week interval. Reliability was assessed by Lin's concordance correlation coefficient (CCC) with a cutoff value of 0.7 indicating test-retest reliab ility. Results: Of the 109 patients 106 (97%) with a median age of 64 years comple ted the study. The number of pads and total weight gain appeared to be reli able measures of the 24, 48 and 72-hour pad tests. For the 24-hour diary th e total number of incontinence episodes was a reliable measure, while the t otal number of voiding episodes was marginally reliable (mean CCC 0.785 and 0.689, respectively). For the 48-hour diary the number of incontinence epi sodes and total number of voiding episodes were reliable measures (mean CCC 0.78 and 0.83, respectively), while for the 72-hour diary each parameter w as highly reliable (CCC 0.86 and 0.826, respectively). However, an increase d test period was associated with decreased patient compliance. Conclusions: The 24-hour pad test and micturition diary are reliable instru ments for assessing the degree of urinary loss and number of incontinent ep isodes, respectively. Increasing test duration to 48 and 72 hours increases reliability but is associated with decreased patient compliance.