THE INTERNATIONAL CONTINENCE SOCIETY (ICS) INCONTINENCE DEFINITION - IS THE SOCIAL AND HYGIENIC ASPECT APPROPRIATE FOR ETIOLOGIC RESEARCH

Objective. To investigate the effect of applying a problem assessment versus a pure symptom urinary incontinence (UI) caseness definition in etiologic research. Subjects. A random population sample of 2613 wome n aged 30-59 years, who responded to a postal questionnaire. Main para meters. One-year period prevalence of the symptom of stress UI; UI ass essed by the woman to be a social and/or hygienic problem; childbirth and history of abdominal, gynecological, obstetric or urologic surgery . Results. Among the 388 women (14.8% of the population sample) who re ported stress UI, 62.6% considered it a social or hygienic problem, an d 21.9% had ever abstained socially because of UI. Applying a problem assessment caseness definition caused under-estimation of the role of childbirth, as compared with analyses including a pure symptom casenes s definition. Conclusion. The International Continence Society (ICS) i ncontinence definition presents intrinsic logical problems that invali dates its use in biomedical, if not in sociomedical, research. As defi nition and medical decision are different concepts, this does not nece ssarily affect the potential utility of the problem assessment aspect when used in everyday clinical practice as a basis for the decision wh ether to treat women with UI or not. (C) 1997 Elsevier Science Inc.