A Simple Test To Diagnose Urinary Incontinence in Women

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The summary below is from the full report titled "The Sensitivity and Specificity of a Simple Test To Distinguish between Urge and Stress Urinary Incontinence." It is in the 16 May 2006 issue of Annals of Internal Medicine (volume 144, pages 715-723). The authors are J.S. Brown, C.S. Bradley, L.L. Subak, H.E. Richter, S.R. Kraus, L. Brubaker, F. Lin, E. Vittinghoff, and D. Grady, for the Diagnostic Aspects of Incontinence Study (DAISy) Research Group.

What is the problem and what is known about it so far?

Urinary incontinence, or involuntary leakage of urine, is common in older women. There are 2 main types. Urge incontinence is sudden, urgent urine leakage. Stress incontinence is urine leakage with coughing, sneezing, or physical activity. Some women have both types. It is currently thought that women must keep a diary of their symptoms and undergo full examination and testing for doctors to make an accurate diagnosis of incontinence. Most women and doctors avoid these because the diary is difficult to keep and the tests are complicated, invasive, and difficult to interpret. As a result, incontinence is not diagnosed or treated in many women. Women and their doctors would benefit from a simpler way to diagnose the different incontinence types.

Why did the researchers do this particular study?

To see whether 3 simple questions can replace complicated testing as a way to diagnose urge and stress incontinence.

Who was studied?

331 women with incontinence at 5 medical centers. All women were at least 40 years of age.

How was the study done?

The researchers asked the women whether they leaked urine, when they leaked urine, and when they leaked urine most often. The women kept a diary of their symptoms and underwent full examination and testing. The researchers compared the information from the 3 questions with that from the diary, examination, and testing to determine whether the questions could accurately diagnose urge and stress incontinence.

What did the researchers find?

Compared with extensive testing, the questions accurately diagnosed urge incontinence about 3 of every 4 times. The questions accurately diagnosed stress incontinence about 2 of every 3 times.

What are the limitations of the study?

Because the questions were not completely accurate, they may not replace full testing in all women. The findings do not apply to women with other types of incontinence or to women who are older than those included in the study. The findings do not prove that question-based diagnosis leads to treatments that improve women's incontinence symptoms.

What are the implications of the study?

Three simple questions can replace complicated testing in some women as a way to diagnose urge and stress incontinence.