Press Release WHO/49 1 July 1998   WORLD HEALTH ORGANIZATION CALLS FIRST INTERNATIONAL CONSULTATION ON INCONTINENCE Leading Medical Experts Move to Reclassify Condition as a Disease and Set Treatment Guidelines MONACO – Medical experts from around the globe assembled under the auspices of the World Health Organization to launch the formal process of classifying incontinence as a disease and raising general awareness of all of its symptoms and ways to prevent it. Bladder control problems affect more than 200 million people worldwide and profoundly affect the quality of life of those who too often silently suffer from its life-disrupting consequences. Overactive bladder is one of the most common and distressing causes of poor bladder control; its symptoms include frequency (urinating more than eight times per 24 hours); urgency (sudden, overwhelming urge to urinate); and/or urge incontinence (sudden and total involuntary loss of urine). The other main cause is stress incontinence, the involuntary leakage of urine when intra-abdominal pressure is suddenly increased (caused by laughing, sneezing or running), due to poor urethral functioning. "This proposed change in the International Classification of Diseases (ICD) would allow the topic of incontinence to be taught properly in medical schools throughout the world and would also send a signal that this very treatable disease should be taken more seriously by the medical community," said Paul Abrams, MD, FRCS, Chairman of the 1st International Consultation on Incontinence (ICI) and Consultant Urological Surgeon at the Bristol Urological Institute, Southmead Hospital. "With impotence now out in the open, bladder control problems seem to be the last real taboo of the 20th Century," he added. "One of our aims, through this meeting, is to help people with bladder control problems realize that they are not alone – they should know that the most common symptoms of urgency, frequency and/or leakage are not a normal part of ageing and should not be afraid to seek medical attention. Doctors are prepared to help with effective medical treatments." The goal of the Consultation is to both raise awareness and reach a consensus on universal treatment guidelines. By creating international guidelines for treatment, health care providers such as general practitioners, urologists, obstetricians, gynaecologists and nurse practitioners will be better able to educate and help those affected with overactive bladder and other bladder control problems. The standardization of information and the establishment of universal treatment guidelines is a crucial step in the effort to identify and treat the millions of people currently suffering from bladder control problems throughout the world. The condition is so widespread, so unmentioned and so damaging to the sufferer's quality of life that a key aim of the consultation was to formally codify incontinence as a disease. Twenty-five committees evaluated the breadth and depth of the incontinence problem worldwide by examining issues ranging from the prevalence of bladder control problems (which are estimated to affect some 10% to 47% of the population, depending on the study), to the economic and quality of life impact bladder control problems have on a local, regional, national and global level. "The World Health Organization is pleased to co-sponsor this First International Consultation on Incontinence," said Dr Alexandre Kalache, Head of the Ageing and Health Programme of WHO. "As diseases continue to be eradicated, and as the population matures in many developing nations as well as in the developed world, conditions which substantially affect quality of life are increasing. Health care systems and providers will face new hurdles in trying to deal with these conditions; however, given the advances in healthcare, we should address those health problems so that people can live healthy, productive lives. One such condition that is largely preventable and treatable, is incontinence – certainly, not an inevitable consequence of ageing. In particular the problems that lead to incontinence for millions of women in the developing world can be prevented through proper obstetric and gynaecological care," he concluded. International Survey Results Unveiled: Need More Doctor/Patient Communication Also presented at the conference were the results of a first-ever survey that suggests diagnosis and treatment of bladder control problems can be improved through better doctor-patient communication. The survey of more than 2,500 primary care physicians in the United States, Europe and Japan revealed that 96% of doctors are persuaded that patients' embarrassment and lack of understanding about bladder control problems are serious barriers to speedy diagnosis and treatment of such conditions. The majority of doctors, the survey found, thought their patients believed at least one or more of the commonly held myths related to bladder control problems. Physicians also reported that the most typical reaction exhibited by patients when they are diagnosed with poor bladder control was not fear nor disbelief, but relief. The Steering Committee of the ICI is composed of high-ranking representatives of the International Consultation on Urological Diseases (ICUD), the international Continence Society, the International Union Against Cancer (UICC), the American Urological Association (AUA), the European Association of Urology (EAU), Confederacion Americana de Uroligia, the Japanese Urological Society, International Federation of Gynecology and Obstetrics (IFGO).

For further information, journalists can contact Dr Alexandre Kalache, Ageing and Health, WHO, Geneva. telephone (41 22) 791 3404, fax (41 22) 791 4839. email: kalachea@who.ch All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.ch/