DIAGNOSTIC CLASSIFICATION OF FEMALE URINARY-INCONTINENCE - AN EPIDEMIOLOGIC SURVEY CORRECTED FOR VALIDITY

Diagnostic questions about stress and urge incontinence were validated against a final diagnosis made by a gynecologist after urodynamic eva luation. Thereafter, an epidemiological survey was performed, using si milar questions, and correcting the answers for lack of validity. Incl uded were 250 incontinent women at the out-patient clinic and 535 wome n who reported incontinence in the epidemiological survey. The sensiti vity for stress incontinence was 0.66 (95% confidence interval +/- 0.0 8), specificity 0.88 (+/- 0.06). The corresponding values for urge inc ontinence were 0.56 (+/- 0.15) and 0.96 (+/- 0.03), and for mixed inco ntinence 0.84 (+/- 0.10) and 0.66 (+/- 0.07). Using these indices of v alidity as corrective measures for the diagnostic distribution reporte d in the epidemiological survey, the percentage of stress incontinence increased from 51 to 77%, while mixed incontinence was reduced from 3 9 to 11%. Pure urge incontinence increased from 10 to 12%. Mixed incon tinence will be overreported in epidemiological surveys. Correction fo r validity indicates that a larger majority than hitherto reported may have pure stress incontinence.