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Evaluation of the 24‐h pad weight test as continence rate assessment tool after artificial urinary sphincter implantation for postprostatectomy urinary incontinence: A Swedish retrospective cohort study
Author(s) -
Reus Christine,
Brattås Izabelle,
Volz Daniela,
Sydén Filip,
Grufman Katarina Hallén,
Mozer Pierre,
RenströmKoskela Lotta
Publication year - 2021
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24723
Subject(s) - medicine , artificial urinary sphincter , interquartile range , urinary incontinence , retrospective cohort study , urology , urinary system , urinary continence , urethral sphincter , cohort , cohort study , quality of life (healthcare) , prostatectomy , surgery , prostate , nursing , cancer
Aim Patient‐reported pad‐count as continence rate assessment tool after artificial urinary sphincter (AUS) implantation is common. However, lack of standardized continence definition using this method results in heterogeneous published efficacy outcomes. Data on 24‐h pad weight tests (PWT) after primary AUS implantation for postprostatectomy urinary incontinence (PPUI) is scarce. Our aim was to evaluate the 24‐h PWT as an efficacy assessment tool and correlate it to qualitative outcomes using validated questionnaires. Methods This retrospective, single center, follow‐up cohort study, evaluated 180 patients who underwent primary AUS implantation for PPUI from 2005 to 2018. Voiding diaries, 24‐h PWT, validated patient satisfaction and quality of life (QoL) questionnaires were collected pre‐operatively and at 3–6 months postactivation, using the institution's Electronic Medical Records. Results The median preoperative and postoperative 24‐h PWT values were 494 (interquartile range [IQR]: 304–780) and 7 (IQR: 0–25) g respectively with a significant improvement in urinary leakage of 489.5 g 99.1% ( p < 0.001). Median preoperative and postoperative I‐QoL results increased from 33.5 (IQR: 19.3–63.6) to 86.4 (IQR: 73.9–94.3) points, with a significant 52.9 points improvement in QoL ( p < 0.001). Similarly, the median preoperative and postoperative ICIQ‐SF values decreased from 20 (IQR: 17–21) to 5 (IQR: 3–9) points, showing a significant improvement of 15 points ( p < 0.001). We also found a significant correlation between PWT and patient satisfaction. Conclusion The 24‐h PWT provides a reliable and objective assessment of continence rates, with a strong correlation to qualitative outcomes, after primary AUS implantation for PPUI. Its use could help reduce reported outcome heterogeneity across studies.