title: The association of Incontinence Symptom Index scores with urethral function and support.
abstract: OBJECTIVE
  The objective of this study was to establish categories of symptom severity based on Incontinence Symptom Index (ISI) scores and to show how these categories are associated with urethral function and support.
  
  
  METHODS
  Women with stress incontinence (n = 97) and asymptomatic controls (n = 98) completed the ISI. Asymptomatic women's scores were between 0 and 6; this range was designated as absent/mild (n = 104). The median score for symptomatic women was 16; scores from 7 to 16 (n = 50) were designated as moderate, and scores of 17 or greater (n = 40) were designated as severe.
  
  
  RESULTS
  Urethral function differed in women with mild, moderate, and severe scores: Valsalva leak point pressure (162.3 vs 123.5 vs 101.9 cm H(2)O; P = .001), cough leak point pressure (202.0 vs 163.0 vs 134.3 cm H(2)O; P = .001), and maximum urethral closure pressure (69.1 vs 44.1 vs 35.3 cm H(2)O; P = .001). Loss of urethrovesical support (point Aa: -1.0 vs -0.6 vs -0.5 cm; P = .004) was found in women with moderate and severe symptoms, compared with those with mild symptoms.
  
  
  CONCLUSIONS
  Categories of symptom severity assessed by the ISI are associated with urethral function and support.
authors.affiliation: Pelvic Floor Research Group, Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Lewicky-Gaupp
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.forename: John O L
authors.initials: JO
authors.lastname: Delancey
authors.forename: Dee E
authors.initials: DE
authors.lastname: Fenner
authors.forename: Edward J
authors.initials: EJ
authors.lastname: McGuire
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Morgan
mesh_terms: D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*