Commentary RE: The Standardization of Terminology in Lower Urinary Tract Function: Report From the Standardization Subcommittee of the International Continence Society

  • Alan Wein
    Address correspondence to: Alan Wein, M.D., Ph.D(hon), F.A.C.S., University of Pennsylvania Health System, Division of Urology, Perelman Center, West Pavilion, 3FL, 34th & Civic Center Boulevard, Philadelphia, PA 19104-1527.
    University of Pennsylvania Health System, Division of Urology, Perelman Center, Philadelphia, PA
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      The International Continence Society (ICS) established the Committee on Standardization of Terminology of Lower Urinary Tract Function in 1973. The first committee report, on Urinary Incontinence and Procedures, related to the evaluation of urine storage, was published in 1976 in various journals. This was first authored by Patrick Bates (the actual individual who first made the statement “the bladder is an unreliable witness”, a quote often attributed erroneously to others. The second report Procedures Related to the Evaluation of Micturition, appeared in 1977 in multiple journals, also first authored by Patrick Bates. The third report, also on Procedures Related to the Evaluation of Micturition and first authored by Patrick Bates, appeared in multiple journals in 1980. The fourth report, similarly first authored by Bates, was on Terminology Related to Neuromuscular Dysfunction of the Lower Urinary Tract and appeared in multiple journals in 1981. The fifth report, Procedures Related to Neurophysiological Investigations, was first authored by Paul Abrams and appeared in multiple journals in 1986 and 1987. There was an additional report on Quantification of Urine Loss, which remained an internal document approved by the Society. In 1990 the ICS Committee on Standardization, chaired by Jens Andersen, published a document entitled “The Standardization of Terminology of Lower Urinary Tract Function Recommended by the International Continence Society” in the International Urogynecology Journal (the first issue of this journal). It included terminology on clinical assessment, procedures related to the evaluation of urine storage and emptying, procedures related to neurophysiological evaluation during filling and emptying, and classification of lower urinary tract dysfunction. The 2002 document was designed to restate and update definitions presented in previous reports and those which were to be published almost simultaneously on urethral function and nocturia. At that time, the ICS was generally acknowledged to be the repository for all standard definitions related to lower urinary tract function and dysfunction. Unfortunately, the waters have gotten a bit muddied since then, with committees and reports from other organizations and competing or modified definitions and descriptions. The 2002 article was the standard of its time and was important in defining what was being talked about insofar as lower urinary tract function/dysfunction was concerned. The ICS and this committee felt that it was necessary to have an agreed upon terminology for critical communication among researchers and clinicians. There were a few items in the report that were controversial and there are a few definitions that have been changed or altered since the report but, for the most part, it has remarkably stood the test of time.
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