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Validity of the incontinence severity index: comparison with pad-weighing tests

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Abstract

The incontinence severity index (ISI) consists of two questions, regarding frequency and amount of leakage. It categorizes urinary incontinence (UI) into slight, moderate, severe, and very severe. The purpose of this study was to test its validity. The index was compared with the results of pad-weighing tests performed by 200 incontinent women referred to a hospital clinic and 103 at a primary care incontinence clinic. Inconvenience was scored by a six-level Likert scale. Mean pad-weighing results (grams per 24 hours, 95% confidence intervals) were 7 (4–10) for slight, 39 (26–51) for moderate, 102 (75–128) for severe, and 200 (131–268) for very severe UI. Spearman’s correlation coefficient for pad-weighing results and severity index was 0.58 (p<0.01), and inconvenience increased significantly with increasing severity. The ISI demonstrated good criterion validity against 24-h pad tests. Good construct validity was indicated by a clear link between ISI and inconvenience.

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References

  1. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjalmas K, Lapitan MC (2002) Epidemiology and natural history of urinary incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 2nd International Consultation on Incontinence. Health Publication Ltd., Plymouth, UK, pp 165–201

    Google Scholar 

  2. Sandvik H, Hunskaar S, Seim A, Hermstad R, Vanvik A, Bratt H (1993) Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey. J Epidemiol Community Health 47:497–499

    Article  PubMed  CAS  Google Scholar 

  3. Sandvik H, Seim A, Vanvik A, Hunskaar S (2000) A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn 19:137–145

    Article  PubMed  CAS  Google Scholar 

  4. Hanley J, Capewell A, Hagen S (2001) Validity study of the severity index, a simple measure of urinary incontinence in women. BMJ 322:1096–1097

    Article  PubMed  CAS  Google Scholar 

  5. Hannestad YS, Rortveit G, Sandvik H, Hunskaar S (2000) A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of incontinence in the county of Nord-Trondelag. J Clin Epidemiol 53:1150–1157

    Article  PubMed  CAS  Google Scholar 

  6. Yu HJ, Wong WY, Chen J, Chie WC (2003) Quality of life impact and treatment seeking of Chinese women with urinary incontinence. Qual Life Res 12:327–333

    Article  PubMed  Google Scholar 

  7. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907

    Article  PubMed  Google Scholar 

  8. Hannestad YS, Lie RT, Rortveit G, Hunskaar S (2004) Familial risk of urinary incontinence in women: population based cross sectional study. BMJ 329:889–891

    Article  PubMed  Google Scholar 

  9. Hägglund D, Walker-Engström ML, Larsson G, Leppert J (2003) Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study. Int Urogynecol J 14:296–304

    Article  Google Scholar 

  10. Iglesias FJG, Ocerin JMCY, Martin JPDM, Gama EV, Perez ML, Lopez MR, Aranguren MVP, Munoz JBG (2000) Prevalence and psychosocial impact of urinary incontinence in older people of a Spanish rural population. J Gerontol 55A:M207–214

    Google Scholar 

  11. Seim A, Sivertsen B, Eriksen BC, Hunskaar S (1996) Treatment of urinary incontinence in women in general practice: observational study. BMJ 312:1459–1462

    PubMed  CAS  Google Scholar 

  12. Indrekvam S, Sandvik H, Hunskaar S (2001) A Norwegian national cohort of 3198 women treated with home-managed electrical stimulation for urinary incontinence—effectiveness and treatment results. Scand J Urol Nephrol 35:32–39

    Article  PubMed  CAS  Google Scholar 

  13. Arya LA, Jackson ND, Myers DL, Verma A (2001) Risk of new-onset urinary incontinence after forceps and vacuum delivery in primiparous women. Am J Obstet Gynecol 185:1318–1323

    Article  PubMed  CAS  Google Scholar 

  14. Kerschan-Schindl K, Uher E, Wiesinger G, Kaider A, Ebenbichler G, Nicolakis P, Kollmitzer J, Preisinger E, Fialka-Moser V (2002) Reliability of pelvic floor muscle strength measurement in elderly incontinent women. Neurourol Urodyn 21:42–47

    Article  PubMed  CAS  Google Scholar 

  15. Chiarelli P, Cockburn J (2002) Promoting urinary continence in women after delivery: randomised controlled trial. BMJ 324:1241

    Article  PubMed  Google Scholar 

  16. Melville JL, Miller EA, Fialkow MF, Lentz GM, Miller JL, Fenner DE (2003) Relationship between patient report and physician assessment of urinary incontinence severity. Am J Obstet Gynecol 189:76–80

    Article  PubMed  Google Scholar 

  17. Donovan JL, Badia X, Corcos J, Gotoh M, Kelleher C, Naughton M, Shaw C, Lukacs B (2002) Symptom and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 2nd International Consultation on Incontinence. Health Publication Ltd., Plymouth, UK, pp 267–316

    Google Scholar 

  18. Donovan JL, Ruud Bosch JLH, Gotoh M, Jackson S, Naughton M, Radley S, Valiquette L (2005) Symptom and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 3rd International Consultation on Incontinence. Health Publication Ltd., Plymouth, UK, pp 519–584

    Google Scholar 

  19. Versi E, Orrego G, Hardy E, Seddon G, Smith P, Anand D (1996) Evaluation of the home pad test in the investigation of female urinary incontinence. Br J Obstet Gynaecol 103:162–167

    PubMed  CAS  Google Scholar 

  20. Artibani W, Andersen JT, Gajewski JB, Ostergard DR, Raz S, Tubaro A, Khullar V, Klarskov P, Rodriguez L (2002) Imaging and other investigations. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 2nd International Consultation on Incontinence. Health Publication Ltd., Plymouth, UK, pp 425–477

    Google Scholar 

  21. Groutz A, Blaivas JG, Chaikin DC, Resnick NM, Engleman K, Anzalone D, Bryzinski B, Wein AJ (2000) Noninvasive outcome measures of urinary incontinence and lower urinary tract symptoms: a multicenter study of micturition diary and pad tests. J Urol 164:698–701

    Article  PubMed  CAS  Google Scholar 

  22. Lose G, Jorgensen L, Thunedborg P (1989) 24-hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence. Acta Obstet Gynecol Scand 68:211–215

    Article  PubMed  CAS  Google Scholar 

  23. O’Sullivan R, Karantanis E, Stevermuer TL, Allen W, Moore KH (2004) Definition of mild, moderate and severe incontinence on the 24-hour pad test. Br J Obstet Gynaecol 111:859–862

    CAS  Google Scholar 

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Acknowledgement

The study was supported by a research grant from Eli Lilly Spain to the Fundacion Clinic for Biomedical Research.

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Correspondence to Hogne Sandvik.

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Sandvik, H., Espuna, M. & Hunskaar, S. Validity of the incontinence severity index: comparison with pad-weighing tests. Int Urogynecol J 17, 520–524 (2006). https://doi.org/10.1007/s00192-005-0060-z

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  • DOI: https://doi.org/10.1007/s00192-005-0060-z

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