title: Reviewing definitions of urinary continence in the contemporary spina bifida literature: a call for clarity.
abstract: BACKGROUND
  Urinary continence is a common goal for children with spina bifida and their physicians. However, definitions of urinary continence vary widely across published studies. We systematically assessed the utilization of common definitions of urinary continence in the spina bifida literature.
  
  
  METHODS
  We searched library databases for reports (2000-2012) describing urinary continence outcomes in children with spina bifida. We assessed various patient-level factors such as age, lesion level, surgical history, and use of additional therapies, as well as study-level factors such as study design, country of origin, continence definition(s), and method of data collection.
  
  
  RESULTS
  Of 473 identified articles, 105 met inclusion criteria, comprising a total of 3209 patients. Of these, 1791 patients (56%) were deemed continent by the study authors. Only 60 studies (57%) clearly defined what they considered to be "continent". The most common definition, used in 24% of all reports, was "always dry". There was no association between journal of publication (p = 0.13), publication year (p = 0.86), study size (p = 0.26), or study country (p = 0.43) and likelihood of a continence definition being included in the manuscript.
  
  
  CONCLUSIONS
  The most frequent definition of urinary continence in the spina bifida literature is "always dry". However, definitions were highly variable, and many authors did not define continence at all. Clinicians and researchers alike would be better able to apply research findings toward improving patient care if continence definitions were more explicitly reported and less variable.
authors.affiliation: Division of Urologic Surgery, Duke University Medical Center, DUMC 3831, Durham, NC 27710, USA. Jessica.C.Lloyd@gmail.com
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Lloyd
authors.forename: Unwanaobong
authors.initials: U
authors.lastname: Nseyo
authors.forename: Ramiro J
authors.initials: RJ
authors.lastname: Madden-Fuentes
authors.forename: Sherry S
authors.initials: SS
authors.lastname: Ross
authors.forename: John S
authors.initials: JS
authors.lastname: Wiener
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Routh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D057566:Self Report; D016135:Spinal Dysraphism / Q000150:complications*; D009626:Terminology as Topic; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000209:etiology
keywords: Neural tube defect; Pediatrics; SB; UI; Urinary incontinence; Urology; spina bifida; urinary incontinence