It has been reported that nearly one-third of all Japanese women have urinary incontinence at some time. Approximately 20 percent are eventually treated, but more women could benefit from treatment. This study was conducted to investigate the utility of a urinary incontinence questionnaire in diagnosing urinary incontinence. In addition to urethrocystometry, x-ray urethrocystography, the pad test, and the cotton swab test, a questionnaire was used to make a definite diagnosis of urinary incontinence. Stress incontinence and urge incontinence were determined with use of a urodynamic mini polygraph (RM-6100, Nihon Kohden, Japan). The questionnaire used was one developed in 1979 by R. Gaudenz of Basle, Switzerland, with some modification to update the questions and make them more suitable for Japanese women (Table 1). Different point values were assigned to each of the 15 questions and were included in the stress incontinence and urge incontinence scores to achieve a stress score and an urge score. The diagnosis was made according to the location of the confluence of stress and urge scores in a grid when they were plotted against each other (Fig. 1).Fig. 1. Diagnostic criteria of the scored urinary incontinence questionnaire. Vertical and horizontal lines indicate stress score (0ndash;26) and urge score (0ndash;26), respectively. Zone a refers to the zone surrounded by a stress score of 19 to 26 and an urge score of 0 to 6. Stress incontinence is designated as zones a through c; urge incontinence, as zones g, i, and j; and mixed incontinence, as zones e, f, and h. Reprinted with permission from Elsevier Science.Table 1.Female urinary incontinence score questionnaireast;ast; Each question was followed by at least two choices and from which subjects choose the most appropriate. Each answer was assigned an urge and stress score ranging from 1 to 3 points. Reprinted with permission from Elsevier Science.One hundred ninety-eight patients were evaluated with a questionnaire and clinical investigation. The results of the questionnaire showed stress incontinence in 110 women and urge incontinence in 31. Forty-six women were described as having mixed incontinence, and 11 were unclassified. In comparison, the clinical diagnoses were stress incontinence in 125, urge incontinence in 29 , mixed incontinence in 41, and overflow incontinence in 3 patients. Overflow incontinence did not have a zone designation in the first stages of the study.The questionnaire score had a sensitivity of 84 percent for diagnosing stress incontinence, 87 percent for urge incontinence, but only 61 percent for mixed incontinence. Seven (67 percent) of the unclassified cases were found to be mixed incontinence on clinical evaluation.Among the 141 patients who were evaluated with the pad test, there was a significant correlation between the severity of the results of the pad test and stress scores (P .001) and urge scores (P .005). The questionnaire was readministered to patients who underwent treatment with Kegel exercises (N equals; 18) or incontinence surgery (N equals; 21) for stress incontinence or anticholinergic drug therapy for urge incontinence (N equals; 12). These 51 women had pre- and posttreatment stress scores of 18.5 plusmn; 2.3 and 3.9 plusmn; 0.7, respectively, and pre- and posttreatment urge scores 20.7 plusmn;4.6 and 4.1 plusmn;0.5, respectively.Int J Gynecol Obstet 2000;68colon;131ndash;137
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