Objectives-To investigate the prevalence of urinary incontinence among people living at home, their responses to it, and its emotional and social effects.Design-Random sample of 4007 adults interviewed in their own homes.Setting-Random sample of 178 constituency sampling points throughout Great Britain.Subjects-1883 men, 2124 women aged 30 and over.Main outcome measures-Responses to questionnaire.Results-6-6% (125) men and 14-0% (297) women had been incontinent of urine at some time-2-8% (52) men and 7.5% (159) women in the previous two months and 61% (124) of these for more than four years. 52% (108) Conclusion-More people with incontinence seem to be consulting their doctors about it than has been found in previous studies, but the procedures carried out by general practitioners still seem to be suboptimal. Urinary incontinence has a profound effect on the day to day lives of most of those who suffer from it. IntroductionDespite great advances in differential diagnosis and management of urinary incontinence in the past 25 years the handicap that it imposes on the sufferer has not been explored to any extent, nor has the way in which help has been sought and the effectiveness of such help. More than one year's delay in reporting the symptom to the family doctor has been recorded in over half of cases, the main reasons for this being the hope that it will go away and embarrassment in talking to the doctor about it.' Even when incontinence has

Sway has been measured by Wright's Ataxiameter in 151 frail elderly and five young subjects, and compared with various sensory modalities. There is a close relationship between increased sway and impaired vibration sense in the legs. No correlations emerged with proprioception but this may reflect the imprecision of the test. That neither vision nor vestibular deprivation correlated with sway confirms the place of these senses as secondary in the maintenance of posture. Vestibular impairment was found in only 6% of the elderly subjects, by tilt test--and these were the very old. There was a limited relationship between falls in the past year and both sway and proprioception.

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Indwelling urethral catheters are used for the long-term management of intractable urinary incontinence or bladder outlet obstruction with resultant retention of urine. There are well-described problems associated with their use including urinary tract infections and mechanical problems. Urinary tract infections have been well researched, however mechanical problems associated with blockage of the catheter lumen due to encrustation, leakage of urine and general discomfort, have been the least investigated. To date, there has been no research of patients' views, understanding or feelings in relation to their catheters. This paper comprises a preliminary investigation of patients' understanding and knowledge of their catheter's location and function, its acceptance, problems associated with its use, social implications and its subsequent management. Thirty-six patients from the community of one health district were surveyed. It was concluded that an indwelling catheter is a prosthesis which, to be successful, requires adequate patient education and management. Education of the patient and carers is particularly important since an understanding of the catheter and its function will lead to better acceptance of the device and will enable better management of the urine drainage system.

The incidence of incontinence in a series of 135 consecutive stroke patients was 51% (urine) and 23% (feces) within one year. In 75% the urinary incontinence started within the first two weeks, and in 41% it had cleared during that time. Incontinence at onset is associated with measures of severity of stroke (and of immobility for fecal incontinence). Among 92 survivors at one year, 15% were incontinent of urine, a proportion that rose in two- and three-year survivors to 23 to 24%, but by four years was again 14%, a level similar to that of the general elderly population. It is concluded that incontinence is more commonly a by-product of immobility and dependency than of involvement of the neurologic pathways, and most of it is transient.