Urinary Incontinence: Out of the Closet

The involuntary loss of urine is an embarrassing and physically uncomfortable condition that affects a broad range of people, from children with persistent enuresis to otherwise healthy young and middle-aged adults to the very elderly living in the community and in nursing homes. Urinary incontinence has been the subject of considerable study by British geriatricians for more than two decades.1,2Yet, it has been only in the last few years that this prevalent, socially disruptive, and extremely costly condition has piqued the interest of researchers, health care providers, health care consumers, and the pharmaceutical and paper products industries in this country. Why has it taken so long for incontinence, whichTimemagazine has labeled "the last of the closet issues" (Time. October 6, 1986:69), to come out of the closet? In this issue ofJAMAthere are two articles that provide some answers and highlight several issues that illustrate