Versi E, Orrego G, Hardy E, Seddon G, Smith P, Anand D
Harvard Medical School, Urogynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Br J Obstet Gynaecol. 1996 Feb;103(2):162-7. doi: 10.1111/j.1471-0528.1996.tb09669.x.
To evaluate the use of the home pad test in the management of patients with urinary dysfunction with reference to feasibility, normal data, reproducibility, compliance and accuracy when compared to video urodynamics.
A prospective study to determine 1. the accuracy of weighing pads by healthcare workers compared to weighing by patients with a spring balance; 2. the effects of evaporation; 3. the pad weight increase in continent women; 4. the compliance over 194 tests in terms of acceptability and feasibility; 5. the reproducibility in 112 women for the 24 h and 48 h tests, 6. the comparison with video urodynamic studies in 149 patients.
A London teaching hospital.
Coefficient of variation and mean deviation analysis were employed to determine the accuracy of measurement. Percentage changes in standardised wet pad weights over a period of 8 weeks were used to determine the rate of weight loss due to evaporation. The percentage of patients completing the test satisfactorily was documented. The increase in the weights of all pads worn during the test period was measured in continent volunteers and incontinent patients. Video urodynamic diagnoses were used as the Gold Standard for comparison.
Twelve perineal pads were weighed by 15 healthcare workers with a resulting coefficient of variation equal to 1.55% (standard error = 0.09%). The mean deviation between patient-measured pad weights and staff-measured weights was 49% (SD = 132%). Pads wetted with saline showed no difference in weight after 1 week and less than 5% change in weight after 8 weeks, with the upper 95% confidence limit of less than 10% loss. The mean pad weight increase over 48 h in continent women was 7.13 g (SD = 4.32 g) giving a 95% upper confidence level of less than 15 g. Compliance was reasonably high with 161 (83%) carrying out the test perfectly. Test-retest analysis of the 24 h and 48 h tests showed a strong relationship with correlation coefficients of 0.90 and 0.94 respectively. The reproducibility was also good, with differences as a percentage of the mean between the first and second test being 6.9% and 1.6% for the 24 h and 48 h tests respectively. There was good concordance when the urodynamic study data was compared with pad weight data in terms of incontinence compared with no incontinence (kappa = 0.65), but a high false positive rate was detected for the pads. When eight of these patients with a false positive pad test had repeat video urodynamic studies, six were found to have detrusor instability on the second study.
The home pad test combined with frequency volume chart documentation is an easy test to perform. It is quite robust and reasonably reproducible. This test should be added to complement the routine urodynamic tests and may have a role in detecting occult detrusor instability.
参照视频尿动力学检查的可行性、正常数据、可重复性、依从性及准确性，评估家用尿垫试验在尿功能障碍患者管理中的应用。
一项前瞻性研究，旨在确定：1. 医护人员称重尿垫与患者用弹簧秤称重的准确性；2. 蒸发的影响；3. 尿失禁女性尿垫重量的增加情况；4. 194项检查在可接受性和可行性方面的依从性；5. 112名女性进行24小时和48小时试验的可重复性；6. 149名患者与视频尿动力学研究的比较。
伦敦一家教学医院。
采用变异系数和平均偏差分析来确定测量的准确性。用8周内标准化湿尿垫重量的百分比变化来确定因蒸发导致的重量损失率。记录满意完成试验的患者百分比。测量试验期间所有佩戴尿垫的大陆志愿者和尿失禁患者尿垫重量的增加情况。将视频尿动力学诊断用作比较的金标准。
15名医护人员对12块会阴尿垫进行称重，变异系数为1.55%（标准误差 = 0.09%）。患者测量的尿垫重量与工作人员测量的重量之间的平均偏差为49%（标准差 = 132%）。用盐水浸湿的尿垫1周后重量无差异，8周后重量变化小于5%，95%置信上限小于10%的损失。尿失禁女性48小时内尿垫平均重量增加7.13克（标准差 = 4.32克），95%置信上限小于15克。依从性相当高，161人（83%）完美完成试验。24小时和48小时试验的重测分析显示出很强的相关性，相关系数分别为0.90和0.94。可重复性也很好，24小时和48小时试验中，第一次和第二次试验之间的差异占平均值的百分比分别为6.9%和1.6%。在尿失禁与无尿失禁方面，尿动力学研究数据与尿垫重量数据比较时一致性良好（kappa = 0.65），但尿垫检测到较高的假阳性率。当这些尿垫试验假阳性的8名患者进行重复视频尿动力学研究时，其中6名在第二次研究中被发现存在逼尿肌不稳定。
家用尿垫试验结合频率 - 尿量图表记录是一项易于执行的试验。它相当可靠且具有合理的可重复性。该试验应作为常规尿动力学检查的补充，可能在检测隐匿性逼尿肌不稳定方面发挥作用。
