Diagnostic classification of female urinary incontinence: an epidemiological survey corrected for validity

J Clin Epidemiol. 1995 Mar;48(3):339-43. doi: 10.1016/0895-4356(94)00147-i.


Diagnostic questions about stress and urge incontinence were validated against a final diagnosis made by a gynecologist after urodynamic evaluation. Thereafter, an epidemiological survey was performed, using similar questions, and correcting the answers for lack of validity. Included were 250 incontinent women at the out-patient clinic and 535 women who reported incontinence in the epidemiological survey. The sensitivity for stress incontinence was 0.66 (95% confidence interval +/- 0.08), specificity 0.88 (+/- 0.06). The corresponding values for urge incontinence were 0.56 (+/- 0.15) and 0.96 (+/- 0.03), and for mixed incontinence 0.84 (+/- 0.10) and 0.66 (+/- 0.07). Using these indices of validity as corrective measures for the diagnostic distribution reported in the epidemiological survey, the percentage of stress incontinence increased from 51 to 77%, while mixed incontinence was reduced from 39 to 11%. Pure urge incontinence increased from 10 to 12%. Mixed incontinence will be overreported in epidemiological surveys. Correction for validity indicates that a larger majority than hitherto reported may have pure stress incontinence.

MeSH terms

  • Adult
  • Epidemiologic Methods*
  • Female
  • Humans
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Urinary Incontinence / classification
  • Urinary Incontinence / diagnosis*
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence, Stress / classification
  • Urinary Incontinence, Stress / diagnosis
  • Urinary Incontinence, Stress / epidemiology
  • Urodynamics