title: Can we, and do we need to, define bladder neck hypermobility and intrinsic sphincteric deficiency? ICI-RS 2011.
abstract: OBJECTIVE
  Bladder neck hypermobility (BNH, also called urethral hypermobility), and intrinsic sphincteric deficiency (ISD) are terms frequently used in the clinical evaluation and management of stress urinary incontinence, and as subject qualifiers in clinical research. The terms also infer pathophysiologic concepts, as BNH and ISD appear to represent two different aspects of failure of the continence mechanism. Unfortunately, neither term is well-defined, and the various clinical and urodynamic characterizations of these terms do not correlate well with one another.
  
  
  METHODS
  The value of these concepts and these specific terms was debated at the ICI-RS meeting, Bristol, UK, June 2011. Two clinicians were asked to take opposing viewpoints, with three weeks lead-time prior to the meeting. Each discussant presented one viewpoint, "for" or "against," followed by a brief discussion to review the presentations.
  
  
  RESULTS
  The consensus was that, while we currently cannot adequately define these terms, there is a need to develop terminology employing these concepts.
  
  
  CONCLUSIONS
  Terminology should permit improved definition of the sphincteric mechanism, allow individual patient characterization and serve as useful waypoints in treatment decisions.
authors.affiliation: Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA. ppsmith@uchc.edu
authors.forename: Phillip P
authors.initials: PP
authors.lastname: Smith
authors.forename: Sanne A L
authors.initials: SA
authors.lastname: van Leijsen
authors.forename: John P F A
authors.initials: JP
authors.lastname: Heesakkers
authors.forename: Paul
authors.initials: P
authors.lastname: Abrams
authors.forename: Anthony R B
authors.initials: AR
authors.lastname: Smith
mesh_terms: D003950:Diagnostic Techniques, Urological / Q000592:standards; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D009626:Terminology as Topic; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D014554:Urination; D014563:Urodynamics