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Abstract
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.