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. 1998 May;91(5 Pt 1):705-9.
doi: 10.1016/s0029-7844(98)00045-3.

Quantification of cough-related urine loss using the paper towel test

J M Miller  1 , J A Ashton-Miller, J O Delancey
Affiliations

Quantification of cough-related urine loss using the paper towel test

J M Miller et al. Obstet Gynecol. 1998 May.

Abstract

Objective: To develop and test a simple and rapid method for quantifying the urine loss resulting from three deep coughs using an ordinary brown paper towel.

Methods: A brown paper towel is held lightly against the perineum during three single coughs performed in the upright stance. The resulting wetted area was calculated using simple geometry; if desired, leakage volume can be interpolated from a calibration curve, which demonstrates the relationship between wetted area (cm2) and volume (mL) of leakage. Four bench tests of the method were performed. In addition, the test-retest reliability of the method was evaluated in eight elderly women with mild stress urinary incontinence, a sample size adequate to detect a 1-mL difference with 80% power.

Results: The smallest measurable quantity of fluid resulted in a wetted area of 0.04 cm2 (equivalent to 0.2 microl). For leakage volumes up to 6 mL, the regression showed that each 1 mL of fluid volume resulted in an average 25.4 cm2 increase in wetted area (coefficient of determination: 0.97). In eight women with stress incontinence 95% of within- and across-visit comparisons of urine loss were within 1 mL.

Conclusion: The paper towel test is a simple and reliable measure providing immediate visual and quantitative feedback of cough-related urine loss typical of mild-to-moderate stress urinary incontinence.

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