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Clinical guidelines

Guidelines for preventive activities in general practice 9th edition

Appendix 13A. The 3 Incontinence Questions (3IQ)

1. During the last three months, have you leaked urine (even a small amount)?

 Yes         No  Questionnaire completed.

2. During the last three months, did you leak urine (check all that apply):

  1. When you were performing some physical activity, such as coughing, sneezing, lifting, or exercise?
  2. When you had the urge or feeling that you needed to empty your bladder, but you could not get to the toilet fast enough?
  3. Without physical activity and without a sense of urgency?

3. During the last three months, did you leak urine most often (check only one):

  1. When you are performing some physical activities, such as coughing, sneezing, lifting, or exercise?
  2. When you had the urge or feeling that you needed to empty your bladder, but you could not get to the toilet fast enough?
  3. Without physical activity or a sense of urgency?
  4. About equally as often with physical activities as with a sense of urgency?
Definitions of the type of urinary incontience are based on responses to Question 3
Score
Response to question 3 Type of incontinence
a. Most often with physical activity Stress only or stress predominant
b. Most often with the urge to empty the bladder Urge only or urge predominant
c. Without pyhsical activity or sense of urgency

Other cause only or other cause predominant
d. About equally with physical activity and sense of urgency Mixed
Reproduced with permission from Brown JS, Bradley CS, Subak LL, et al. The sensitivity and specificity of a simple test to distinguish between urge and stress incontinence. Ann Intern Med 2006,144910):715-23.  
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