Presentation Authors: Yooni Yi*, Dallas, TX, Christopher Graziano, Birmingham, AL, Nabeel Shakir, Michael Davenport, Dallas, TX, Brian Christine, Birmingham, AL, Rachel Bergeson, Allen Morey, Dallas, TX
Introduction: We previously proposed the standing cough test (SCT) as a method of providing rapid, objective assessment of incontinence severity via the Male Stress Incontinence Grading Scale (MSIGS). Previous data has shown that MSIGS has a strong correlation to patient-reported pads per day (PPD), improving male sling selectivity and outcomes. We sought to assess the correlation between the patient history, MSIGS results, and 24-hour pad weights to provide an external validation of MSIGS as an objective measure of male stress urinary incontinence (SUI) severity.
Methods: A retrospective review of a single surgeon, high volume prosthetic urology database was conducted to identify men evaluated for anti-incontinence surgery. All patients had 24-hour pad weight and standing cough tests completed preoperatively. MSIGS was used to record the severity of SUI in this population and results were compared to pad weights. We determined the Spearman's correlation and coefficient between the MSIGS grading and pad weights.
Results: There were 113 patients identified who underwent an AdVance Sling (n=69) or Artificial Urinary Sphincter (AUS, n=40). In the sling group, a majority (95.6%) of patients had an MSIGS of 0-2. In the AUS group, the majority of patients (67.5%) had an MSIGS of 3 or 4. The Spearman's coefficient between MSIGS and 24-hour pad weight for the overall group was Ï=0.68 (p < 0.0001) demonstrating a strong positive correlation. In contrast, PPD as reported by patient history was not as strongly correlated with pad weight (Ï= 0.54, p < 0.0001). In a multivariable model predicting pad weight, it was shown that the effect of MSIGS was greater than PPD (Î²= 83 [54-111], p < 0.0001 vs 45 [21-69], p = 0.0004).
Conclusions: Physical demonstration of male SUI using SCT provides a rapid, objective assessment of SUI severity. These data validate that MSIGS is an effective surrogate for 24-hour pad weights. The SCT is promising as a non-invasive test that can be utilized as a primary assessment for male anti-incontinence procedures.