One hundred and one women were studied between March 1997 and December 1998, at the North Paraná Regional University Hospital, Londrina, Paraná State, Brazil. They were split into 2 groups, Group 1 (51 with urine leak), Group 2 (50 without urine leak). These women were made aware of the procedures and signed an informed consent form, which was approved by the ethics committee.
Clinical evaluation included clinical, obstetrics and gynecological history, and subjective evaluation of urinary leaks.
Body mass index (BMI) was calculated using the formula BMI = W/H2 where: 18-25 kg/m2 is normal; 25-30 kg/m2 is overweight; 30-40 kg/m2 is obesity, and >40 kg/m2 is morbid obesity 15.
Subjective evaluation included: circumstances or situations in which urine leak occurs such as coughing, sneezing, laughing, climb stairs, evacuation, coitus, etc (Table 1). Subjective evaluation also included: urine leak provoked by the sound of, or interaction with, water; the number of leak occurrences; and pad changes during a 24-hour period.
Urinary habits were evaluated by the number of morning micturiations and nycturia, and quantity of liquid ingested.
To evaluate psychosocial impact and inconvenience in daily and social activities, patient discomfort and humidity sensation was measured on a 1 – 5 ascending scale.
We used the 60-minute pad test for objective evaluation of urinary leak. A predetermined quantity of water and a pad of known weight were given to the patient at the beginning of the test. After several predefined physical activities, the pad was weighed16.
Statistical analysis was performed using the Goodman test of simultaneous confidence intervals for contrasts between multinomial populations, and the nonparametric Mann-Withney test for relationships between the number of micturitions and leaks per day 17,18, 19.
The Chi-square test was used to compare the subjective and objective evaluations 17. All statistic tests were performed with a 0.05 significance level.











Table 1 – Subjective evaluation classification


Continence, patients without urinary leak


Mild urinary incontinence, patients with urine leak during sneezing and coughing


Moderate urinary incontinence, patients with urinary leak during laughing, climbing or descending stairs, evacuation or coitus.


Grave urinary incontinence, patients with urinary leak at rest.