The Classification and Diagnosis of Urinary Incontinence in Women
JAMES S. KRIEGER, M.D.
Department of Obstetrics and Gynecology
RALPH A. STRAFFON, M.D.
Department of Urology
WOMEN subject to urinary incontinence often are reluctant and ashamed to admit it, and they may be slow to seek medical attention because they believe that theirs is a unique disability. They curtail their social activities because of the constant insecurity resulting from unpredictable loss of urine with consequent odor and irritation. They may resort to various articles of protection, such as pads, rubber pants or aprons, and even towels, before seeking medical help. As a result, the physician who corrects the defect, and restores the patient’s composure so that she may resume normal activities, will have an eternally grateful patient besides achieving great satisfaction himself.
The many causes of urinary incontinence make it imperative that a correct diagnostic evaluation be made if treatment is to be successful. A faulty diagnosis may lead to the wrong therapy that may make the condition considerably worse and thereby may jeopardize the results of secondary treatment. For these reasons, we propose to classify the types of urinary incontinence and to present the diagnostic studies we have found to be most helpful in evaluating this condition. The cooperative efforts of the gynecologist and the urologist are most desirable for thorough investigation of this complex problem.
Classification of Incontinence
There are five types of incontinence: (1) stress incontinence, (2) urgency incontinence, (3) dribbling incontinence with otherwise normal voiding, (4) dribbling incontinence with no voiding, (5) paradoxical or overflow incontinence.
(1) Stress incontinence is characterized by progressive involuntary loss of urine when physical activity such as . . .