Distress and delay associated with urinary incontinence, frequency, and urgency in women.

It is ironic that though many personal topics may be and Gynaecology openly discussed with patients or in the media, uro-(Urodynamic Unit), St logical symptoms are still largely avoided. Yet urinary George's and St James's complaints are common among women, although exact Hospitals,London prevalence is difficult to estimate because various clinicAl 'researchow researchers use different definitions of severity and S L Stanton, FRCOG, patients have different thresholds for complaint. consultant and honorary senior Nemir and Middleton' found occasional stress inconti- lecturer nence in half of the premenopausal women they studied, and Brocklehurst2 estimated the prevalence of Clinical Epidemiology and urgency, frequency, and nocturia in elderly women to Social Medicine, St be 60%. Using stricter criteria, Yarnell et al found that George's Hospital Medical 3-7% of women in the general population complained School, London of "significant" urinary incontinence.3 L turer It seems that patients who present to their doctor lecturer P M Sedgwick, BSC, complaining of various urinary symptoms, from statistical assistant occasional episodes to constant leakage, share one common factor: the problem has become so personally Correspondence to: Mr worrying that the patient is compelled to seek medical S L Stanton, Urodynamic advice. Thomas et al found that only a third of women Unit, Department of complaining of moderate or severe incontinence were Obstetrics and Gynaecology, receiving medical care or help from the social services.4 St George's Hospital, In the study by Yarnell et al of the women who Cranmer Terrace, London TerRacE reported that urinary symptoms interfered with social SW17 ORE.