Urinary incontinence and quality of life

Urinary incontinence affects 15–30% of people of all ages. It can affect the social, psychological, domestic, occupational, physical and sexual aspects of their lives. Traditional assessment of urinary incontinence has been based on symptom scores and objective investigations concentrating on its aetiology, diagnosis and treatment. Recently, a more multidimensional approach to urinary incontinence has incorporated the concept of quality of life (QoL) in its routine evaluation. The different aspects of QoL can be assessed using two main types of questionnaire: generic and condition-specific questionnaires. Whereas generic questionnaires cover a wide range of different health states, condition-specific questionnaires reflect a particular condition, and are more relevant to patients’ symptoms, the bother they cause and how their lives are affected. Development of a QoL questionnaire in urinary incontinence is a complex task and requires the end result to be a reproducible measure of QoL. The final questionnaire is usually made up of a number of questions presented in different sections, with each section measuring a specific domain of QoL experienced by patients. Several QoL questionnaires are available in urinary incontinence. Selecting the most appropriate questionnaire is not a straightforward choice. In an attempt to simplify this, in 1998 the first International Consultation on Incontinence (ICI) proposed the concept of the modular ICI questionnaire (ICIQ), as an instrument that utilized the strengths of each individual questionnaire. In order to make questionnaires easier to use in clinical practice, short-form and screening versions of the most commonly used questionnaires are being developed.