Ped Testi
Özet
Ped testi, idrar kaçırmanın varlığını ve şiddetini değerlendirmede kullanılan, emici pedin ağırlık artışına dayalı tanısal bir yöntemdir. İdrar kaçırmanın tipini belirleyemese de miktarını saptamak, tanı ve tedavi sürecinde önemli katkı sağlar. Testler sürelerine göre kısa (<1 saat, 1 saat) ve uzun (24–48 saat) olarak sınıflandırılır. Uluslararası Kontinans Derneği tarafından standardize edilen 1 saatlik ped testi, stres ve karışık tip idrar kaçırmada yüksek özgüllük gösterir; ancak duyarlılığı sınırlıdır. 24 saatlik ped testi ise daha tekrarlanabilir olmakla birlikte, günlük aktivite farklılıklarına bağlı değişkenlik gösterir ve standardizasyonu zordur. 48 saatlik testler daha hassas olsa da hasta uyumu düşük olduğundan nadiren uygulanır. Ped testi, özellikle cerrahi öncesi ve sonrası karşılaştırmalarda, ayrıca erkeklerde idrar kaçırma şiddetini ve cerrahi teknik seçimini değerlendirmede önerilmektedir. Farklı gramaj eşikleriyle şiddet sınıflaması yapılır: kısa süreli testlerde 1–10 g hafif, >50 g şiddetli; 24 saatlik testlerde ≥75 g şiddetli kabul edilir. Tam anlamıyla “altın standart” olmamakla birlikte, ped testleri kendi kendini değerlendirme anketleriyle (SQ, ICIQ-SF) birlikte kullanıldığında klinik açıdan güvenilir sonuçlar sağlar.
Referanslar
Abrams P, Cardozo L, Dmochowski R, Wein A. Seventh International Consultation on Incontinence—Research society 2017. Neurourol Urodyn. 2018 Jun;37(S4). DOI: 10.1002/nau.23783
Nambiar AK, Arlandis S, Bø K, Cobussen-Boekhorst H, Costantini E, de Heide M, et al. European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. Eur Urol. 2022 Jul;82(1):49–59.
Sacco E, Bientinesi R, Gandi C, Di Gianfrancesco L, Pierconti F, Racioppi M, et al. Patient pad count is a poor measure of urinary incontinence compared with 48-h pad test: results of a large-scale multicentre study. BJU Int. 2019 May;123(5A):E69–78.
Song X, Zhu L, Ding J. The value of the preoperative 1-h pad test with pessary insertion for predicting the need for a mid-urethral sling following pelvic prolapse surgery: a cohort study. World J Urol. 2016 Mar;34(3):361–7.
Kopp DM, Bengtson AM, Tang JH, Chipungu E, Moyo M, Wilkinson J. Use of a postoperative pad test to identify continence status in women after obstetric vesicovaginal fistula repair: a prospective cohort study. BJOG Int J Obstet Gynaecol. 2017 May;124(6):966–72.
Painter V, Karantanis E, Moore KH. Does patient activity level affect 24-hr pad test results in stress-incontinent women? Neurourol Urodyn. 2012 Jan;31(1):143–7.
Peters KM, Macdiarmid SA, Wooldridge LS, Leong FC, Shobeiri SA, Rovner ES, et al. Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol. 2009 Sep;182(3):1055–61.
Wang M, Jian Z, Ma Y, Jin X, Li H, Wang K. Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis. Int Urogynecology J. 2020 Dec;31(12):2457–71.
Shamliyan T, Wyman J, Kane RL. Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012; [cited 2025 Mar 1].Available from: http://www.ncbi.nlm.nih.gov/books/NBK92960/
Abdel-fattah M, Barrington JW, Youssef M. The standard 1-hour pad test: does it have any value in clinical practice? Eur Urol. 2004 Sep;46(3):377–80.
Karantanis E, Fynes M, Moore KH, Stanton SL. Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):111–6; discussion 116.
Referanslar
Abrams P, Cardozo L, Dmochowski R, Wein A. Seventh International Consultation on Incontinence—Research society 2017. Neurourol Urodyn. 2018 Jun;37(S4). DOI: 10.1002/nau.23783
Nambiar AK, Arlandis S, Bø K, Cobussen-Boekhorst H, Costantini E, de Heide M, et al. European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. Eur Urol. 2022 Jul;82(1):49–59.
Sacco E, Bientinesi R, Gandi C, Di Gianfrancesco L, Pierconti F, Racioppi M, et al. Patient pad count is a poor measure of urinary incontinence compared with 48-h pad test: results of a large-scale multicentre study. BJU Int. 2019 May;123(5A):E69–78.
Song X, Zhu L, Ding J. The value of the preoperative 1-h pad test with pessary insertion for predicting the need for a mid-urethral sling following pelvic prolapse surgery: a cohort study. World J Urol. 2016 Mar;34(3):361–7.
Kopp DM, Bengtson AM, Tang JH, Chipungu E, Moyo M, Wilkinson J. Use of a postoperative pad test to identify continence status in women after obstetric vesicovaginal fistula repair: a prospective cohort study. BJOG Int J Obstet Gynaecol. 2017 May;124(6):966–72.
Painter V, Karantanis E, Moore KH. Does patient activity level affect 24-hr pad test results in stress-incontinent women? Neurourol Urodyn. 2012 Jan;31(1):143–7.
Peters KM, Macdiarmid SA, Wooldridge LS, Leong FC, Shobeiri SA, Rovner ES, et al. Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. J Urol. 2009 Sep;182(3):1055–61.
Wang M, Jian Z, Ma Y, Jin X, Li H, Wang K. Percutaneous tibial nerve stimulation for overactive bladder syndrome: a systematic review and meta-analysis. Int Urogynecology J. 2020 Dec;31(12):2457–71.
Shamliyan T, Wyman J, Kane RL. Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012; [cited 2025 Mar 1].Available from: http://www.ncbi.nlm.nih.gov/books/NBK92960/
Abdel-fattah M, Barrington JW, Youssef M. The standard 1-hour pad test: does it have any value in clinical practice? Eur Urol. 2004 Sep;46(3):377–80.
Karantanis E, Fynes M, Moore KH, Stanton SL. Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):111–6; discussion 116.
