Urinary Incontinence in Adults Guideline Update Panel

• J. Andrew Fantl, MD
• Co-Chair
• Professor and Vice Chairman
• Department of Obstetrics, Gynecology and Reproductive Medicine
• Division of Gynecology and General Obstetrics
• State University of New York at Stony Brook
• Stony Brook, New York
• Specialty: Obstetrics/Gynecology
• Dr. Fantl served for 20 years as professor in the Department of Obstetrics and Gynecology before assuming his present position. Dr. Fantl is past president of the American Urogynecologic Society and the Society of Gynecologic Surgeons. He currently serves on advisory groups to the International Continence Society and help for Incontinent People. His research interests have been urinary incontinence and pelvic organ prolapse in women, areas in which he has published for the past 15 years. He has been the principal investigator of NIH-NIA funded collaborative research on urinary incontinence and has patented a sensor catheter in collaboration with the National Aeronautics and Space Administration.

• Diane Kaschak Newman, RNC, MSN, FAAN
• Co-Chair
• Adult Nurse Practitioner
• Access to Continence Care & Treatment, Inc.
• Philadelphia, Pennsylvania
• Specialty: Nursing
• Ms. Newman is an adult nurse practitioner, consultant, educator, and international speaker specializing in the areas of urinary incontinence and the management of incontinence. She holds a Master's degree in Nursing from the University of Pennsylvania. Her private practice, DKN & Associates and Golden Horizons, provides evaluation and treatment in office practice, long-term care settings for adult patients, and home care services for incontinent clients. Ms. Newman is founder and President of Access to Continence Care & Treatment, Inc., an organization that actively promotes the development of incontinence services and produces educational materials on incontinence for health care providers. Ms. Newman participated in the University of Pennsylvania School of Nursing Urinary Incontinence Project in 1986 and was involved with several research projects on the effect of behavioral treatment for urinary incontinence. She was a nurse practitioner consultant to the VNA of Trenton/Robert Wood Johnson Foundation demonstration project, Urinary Incontinence in a Visiting Nursing Agency. Ms. Newman is a clinical faculty preceptor in the geriatric and adult nurse practitioner programs at the University of Pennsylvania School of Graduate Nursing and was chair of the Second National Multi-Specialty Nursing Conference on Urinary Continence held in January 1994. Ms. Newman has presented scientific papers at national and international meetings, written journal articles, and contributed chapters to publications on the subject of incontinence. She is the editor of the geriatric nursing textbook, Geriatric Care Plans.

• Joyce Colling, PhD, RN, FAAN
• Professor and Chairperson
• Community Health Care Systems Department
• School of Nursing
• Oregon Health Sciences University
• Portland, Oregon
• Specialty: Nursing
• Dr. Colling is a nurse and professor specializing in issues of gerontology. She has contributed much to research on incontinence in the frail elderly in the community and particularly in long-term care settings, with emphasis on staff education to improve incontinence care, and has published numerous research articles on incontinence in the elderly. She provides continence services to clinic patients and consultation to nursing home and community agencies. She is a fellow of the American Academy of Nursing and the Gerontological Society of America and currently serves on two international panels on urinary incontinence.

• John O.L. DeLancey, MD
• Associate Professor and Director of Gynecology
• Department of Obstetrics and Gynecology
• University of Michigan Medical Center
• Ann Arbor, Michigan
• Specialty: Obstetrics/Gynecology
• Dr. DeLancey's area of research focuses on understanding the pathophysiology of urinary incontinence and problems with pelvic organ support. His clinical practice centers around surgical management of urinary incontinence and pelvic organ prolapse. He is president-elect of the American Urogynecologic Society and has lectured extensively in the United States and abroad concerning urinary incontinence.

• Christopher Keeys, PharmD
• President
• Clinical Pharmacy Associates
• Calverton, Maryland
• Specialty: Pharmacy
• Dr. Keeys is presently co-founder and president of Clinical Pharmacy Associates, Inc. He received his Bachelor of Science degree, magna cum laude, from Howard University in 1980 and his Doctor of Pharmacy degree in 1982 from the Philadelphia College of Pharmacy and Sciences. He is a registered pharmacist in Washington, DC, Maryland, Virginia, and Pennsylvania. During the past 15 years of professional life he has provided, through innovation and team building, progressive pharmaceutical services for many health care organizations, and served as a teacher of students and colleagues. His works and writings on the subjects of drug information, adverse drug reactions, and contemporary pharmacy practice have been published in professional and public press both in the United States and abroad. He has been active in local and national professional organizations and is currently serving as Chairman, Drug Use Review Board, District of Columbia, and Co-Vice Chairman, Chesapeake Research Review, Inc., an ethical research committee. Dr. Keeys has been honored as the recipient of the Honored Preceptor Award from the Doctor of Pharmacy Class, Howard University; Pharmacist of the Year award from the Washington Metropolitan Society of Hospital Pharmacists; and Distinguished Pharmacy Alumnus Award from the Howard University Pharmacy Alumnus Association.

• Richard M. Loughery, LFACHA
• Planning Consultant
• National Museum of Health and Medicine
• McLean, Virginia
• Specialty: Hospital Administration, Consumer Representative
• Mr. Loughery served as special assistant and director of the Advisory Committee Office of the Secretary of the Department of Health and Human Services, Public Health Service. In this position, he advised the Secretary about a variety of health care and policy issues. For over 20 years he was the chief executive officer and president of the Washington Hospital Center, a 910-bed teaching hospital. He has served in leadership positions with the American Hospital Association and the American College of Hospital Administrators.

• B. Joan McDowell, PhD, CRNP, FAAN
• Associate Professor of Nursing
• University of Pittsburgh
• Pittsburg, Pennsylvania
• Specialty: Nursing
• Dr. McDowell received her doctorate in Higher Education Administration at the University of Pittsburgh. Since 1981, she has been affiliated with the University of Pittsburgh School of Medicine, where she serves as associate professor of nursing, director of the continence program, and assistant research professor of medicine. Dr. McDowell is a Fellow in the American Academy of Nursing and the recipient of many awards, including the Pennsylvania Nurses Association Commonwealth Award for Nursing Practice, the Award of Excellence from the American Academy of Nurse Practitioners, and inclusion in Who's Who in American Nursing. She has been the principal investigator for the Behavioral Treatment of Urinary Incontinence in Homebound Elderly since 1992, and during that time has authored and coauthored several articles on the identification and treatment of urinary incontinence.

• Peggy A. Norton, MD
• Associate Professor
• Department of Obstetrics and Gynecology
• University of Utah School of Medicine
• Salt Lake City, Utah
• Specialty: Obstetrics/Gynecology
• Dr. Norton is a gynecologist specializing in urodynamics and surgery for urinary incontinence and genital prolapse. She has published numerous papers on these two subjects, and has co-authored three textbooks on urinary incontinence. She is principal investigator on an NIH-funded study on the role of connective tissue in genitourinary prolapse. She is currently the research chairman for the American Urogynecologic Society and serves on several national and international advisory panels for the NIH, Society of Gynecologic Surgeons, and the International Continence Society. She recently won a teaching award from the American College of Obstetricians and Gynecologists.

• Joseph Ouslander, MD
• Vice President, Medical Affairs
• Jewish Home for the Aging
• Associate Professor
• Multicampus Division of Geriatric Medicine and Gerontology
• UCLA School of Medicine
• Reseda, California
• Specialty: Geriatrics
• Dr. Ouslander is associate professor of medicine in the Multicampus Division of Geriatric Medicine and Gerontology at the University of California, Los Angeles School of Medicine, associate director of the Borun Center for Gerontological Research, and director of Gerontology at Encino Hospital. Dr. Ouslander has served on several national and international panels on urinary incontinence, has published numerous research articles on incontinence and has coauthored two books. He currently serves on the Board of Directors of the American Geriatrics Society and has served on the Geriatric Medicine Test Committee of the American Board of Internal Medicine/American Board of Family Practice.

• John F. Schnelle, PhD
• Director and Professor-in-Residence
• Borun Center for Gerontological Research
• UCLA School of Medicine and Jewish Home for the Aging
• Reseda, California
• Specialty: Psychology, Gerontology
• Dr. Schnelle is director of the Borun Center for Gerontological Research and a professor at the Multicampus Division of Geriatric Medicine and Gerontology, School of Medicine, University of California, Los Angeles. He is known for his role as principal investigator on several major clinical trial intervention grants designed to improve care and management in nursing homes and has received awards for his outstanding contributions to behavior therapy. Among his most notable contributions is his innovative work in incontinence care, comprehensively described in his book, Management of Urinary Incontinence in the Frail Elderly. Dr. Schnelle has published in the areas of quality control in institutional settings and quality of life issues in the frail elderly, with over 100 publications in professional books and journals.

• David R. Staskin, MD
• Director
• Urodynamics and Incontinence Center
• Harvard Medical School
• Beth Israel Hospital
• Boston, Massachusetts
• Specialty: Urology
• Dr. Staskin is an assistant professor of surgery/urology at Harvard Medical School and Director of the Urodynamics and Continence Center at Beth Israel Hospital in Boston, where he holds teaching positions in both the divisions of Urology and Gynecology. He is also the Chief of Surgery at Malden Hospital. He currently serves on the Outcome Measures Committee for the International Continence Society, the Board of Directors of the American Urogynecologic Society and the Massachusetts Multiple Sclerosis Association, and is a member of the Urodynamics Society of the American Urological Association. His research and clinical interests are concentrated in the evaluation and treatment of incontinence and voiding dysfunction.

• Jeannette M. Tries, MS, OTR
• Director
• Biofeedback and Incontinence Centers
• Sacred Heart Rehabilitation Hospital
• Milwaukee, Wisconsin
• Specialty: Occupational Therapy, Psychology
• Ms. Tries is president of the Clinic for Neurological Learning and is a consultant to the University of Illinois Incontinence Service within the Colon-Rectal Surgery Department. A registered occupational therapist and certified biofeedback therapist, Ms. Tries has developed neuromuscular reeducation and incontinence biofeedback programs. She is past president of the Biofeedback Society of Wisconsin, past board member of the Biofeedback Certification Institute of America, as well as consultant to faculties developing electromyographic neuromuscular reeducation and incontinence programs. Ms. Tries has a strong interest in development of behavioral and reeducation strategies for the neurologically impaired.

• Vernon C. Urich, MD
• Chief
• Urology Section and Urodynamic Lab
• Carl T. Hayden VA Medical Center
• Phoenix, Arizona
• Specialty: Urology
• Dr. Urich is a urologist, surgeon, and educator, whose main interest is patient education. He was president of the Michigan Urological Society in 1990 and was on that Society's Board of Directors for 5 years. He is currently on the editorial board of Patient Education and Counseling and formerly was on the board of directors of the International Patient Education Council and the board of trustees of the Center for Gerontology. He was a member of the Urinary Incontinence Guideline Panel and now serves on the VA Institute of Quality Management Guideline Panel. Prior to recent relocation, he was on the faculty of the University of Michigan and Michigan State University.

• Sharon H. Vitousek, MD
• Waimea Medical Associates
• Lucy Henriques Medical Center
• Kamuela, Hawaii
• Specialty: Primary Care, Community Health
• Dr. Vitousek received her medical degree from the John Burns School of Medicine in Hawaii. Currently, she is president of the State of Hawaii Board of Health, and maintains a part-time internal medicine practice with Waimea Medical Associates. She has also worked as a clinical professor of medicine for Queen Emma Clinic. Dr. Vitousek has long been involved in community efforts to improve the health status of individuals in North Hawaii. She wrote the mission statement for North Hawaii Community Hospital, Inc., worked with the Department of Health to develop a public/private partnership for its funding, developed a proposal to procure a $2 million grant for the hospital, and served as its president. In 1994, Dr. Vitousek was elected to the Hawaii Medical Association House of Delegates.

• Barry D. Weiss, MD
• Professor of Family Medicine
• Department of Family and Community Medicine
• University of Arizona
• College of Medicine
• Tucson, Arizona
• Specialty: Family Medicine, Geriatrics
• Dr. Weiss serves on national committees of the American Academy of Family Physicians, the National Cancer Institute, and the Agency for Health Care Policy and Research. He is editor of Family Medicine, the national journal of the Society of Teachers of Family Medicine. Dr. Weiss is the author of over 80 publications in peer-reviewed medical journals, and serves on the Arizona Board of Medical Examiners, the regulatory agency responsible for licensing and disciplining physicians who practice medicine in Arizona.

• Kristene Whitmore, MD
• Chief of Urology
• Director of the Incontinence Center
• The Graduate Hospital
• Philadelphia, Pennsylvania
• Specialty: Urology
• Dr. Whitmore, in addition to her responsibilities at The Graduate Hospital, also serves on the urology staff for the Philadelphia Veteran's Administration Hospital and is a clinical professor of urology at the University of Pennsylvania. Over the past 16 years, Dr. Whitmore has presented nationally and internationally and has authored or coauthored more than 100 articles and books. Dr. Whitmore has made numerous television appearances, and served for 3 years as a medical consultant for the Emmy award-winning drama, "St. Elsewhere." She has also provided consultation to Searle, Merck, Sharp and Dohme, Marion, Johnson & Johnson, and Wang laboratories. Dr. Whitmore is a member of the American Medical Association, American Association of Clinical Urologists, American Urogynecological Society, American Foundation for Urologic Diseases, National Kidney Foundation, and International Continence Society. She was the 1994 president of Women in Urology and was listed in Who's Who Worldwide.

Consultants

• Patricia Burns, PhD, RN, FAAN
• Director, School of Nursing
• Department of Graduate Education
• SUNY of Buffalo
• Buffalo, New York

• Ananias Diokno, MD
• Chief, Department of Urology
• William Beaumont Hospital
• Royal Oak, Michigan

• Teh-Wei Hu, PhD
• Professor of Health Economics
• Department of Social and Administrative Health Sciences
• Berkeley, California

• Donna Katzman McClish, PhD
• Associate Professor
• Department of Biostatistics
• Medical College of Virginia
• Richmond, Virginia

• Thelma Joan Wells, PhD, RN, FAAN
• University of Wisconsin School of Nursing
• Madison, Wisconsin

• Matthew Zack, MD, MPH
• Centers for Disease Control and Prevention
• Atlanta, Georgia

AHCPR Staff

• Douglas B. Kamerow, MD, MPH
• Director
• Office of the Forum for Quality and Effectiveness in Health Care

• Francis Chesley, MD
• Senior Health Policy Analyst

• Margaret Coopey, MGA, RN
• Senior Health Policy Analyst

• Stan Edinger, MD
• Senior Health Policy Analyst

• Carole Hudgings, PhD
• Senior Health Policy Analyst

• Lawrence C. McMurtry, MSSW
• Senior Health Policy Analyst

• Randie A. Siegel
• Managing Editor

• Karen N. Carp
• Public Affairs Specialist

Contract Support

Technical Resources International, Inc

• Gail J. Herzenberg, MPA
• Project Director
• Cheryl Campbell
• Panel Manager
• Marcia Feinleib
• Managing Editor
• Joan A. Saunders
• Panel Editor
• Joanna Taylor
• Production Editor
• David Tran
• Literature Acquisition Specialist
• John Warner, MS
• Research Analyst

Peer Reviewers [a]

[a] These individuals provided peer review. Their participation does not necessarily imply endorsement of the guideline.

• Anne Alberg
• Vice President, Sales and Marketing
• Diagnostic Ultrasound Corporation
• Redmond, Washington

• Margaret M. Baumann, MD
• Section of Geriatric Medicine
• University of Illinois at Chicago
• Chicago, Illinois

• Kari Bo, PE, PT, PhD
• Associate Professor
• The Norwegian University of Sport and Physical Education
• Oslo, Norway

• Carol Brink, MPH, RN
• Associate Professor of Clinical Nursing
• University of Rochester School of Nursing
• Rochester, New York

• Norman Bruckner, PhD
• Director, Product Development
• Johnson & Johnson
• Arlington, Texas

• Richard Bump, MD
• Associate Professor
• Department of Obstetrics/Gynecology
• Duke University
• Durham, North Carolina

• Kathryn Burgio, PhD
• Associate Professor of Medicine
• Division of Gerontology and Geriatric Medicine
• University of Alabama
• Birmingham, Alabama

• Amanda Clark, MD
• Oregon Health Sciences University
• Portland, Oregon

• Dr. Alan Cottenden
• Lecturer
• Department of Medical Physics and Bioengineering
• University College London
• London, England

• Molly Dougherty, PhD, RN
• Professor and Research Coordinator
• University of Florida
• College of Nursing
• Gainesville, Florida

• Carol Einhorn, RN
• Gerontological Nurse Practitioner
• VA West Side Medical Center
• Chicago, Illinois

• Sheila Fiers, RN, BSN, CETN
• Rochester, Minnesota

• Norman F. Gant, MD
• Executive Director
• American Board of Obstetrics/Gynecology
• Dallas, Texas

• Mikel Gray
• Department of Urology
• University of Virginia Health Sciences Center
• Charlottesville, Virginia

• Constance Halverson, RN
• Clinical Research Advisor
• EMPI, Inc.
• Minneapolis, Minnesota

• Kay E. Jewell, MD
• Health Care Financing Administration
• Baltimore, Maryland

• Aaron Kirkemo, MD
• Director, Urodynamics Laboratory
• Henry Ford Hospital
• Detroit, Michigan

• Beverly Korfin, RN
• Urologic Division
• CR Bard, Inc.
• Covington, Georgia

• Rhonda Kotarinos, MS, PT
• President
• Women's Therapeutic Services, Ltd.
• Chicago, Illinois

• Gary Leach, MD
• Department of Urology
• Kaiser Permanente Medical Center
• Los Angeles, California

• Deborah Lekan-Rutledge, MSN
• University of North Carolina, Chapel Hill
• Chapel Hill, North Carolina

• Edward McGuire, MD
• Professor and Director
• Division of Urology
• University of Texas-Houston
• Houston, Texas

• Mark McIntyre
• American Medical Systems
• Minneapolis, Minnesota

• Joseph Montella, MD
• Assistant Professor
• Department of Obstetrics and Gynecology
• Jefferson Medical College
• Philadelphia, Pennsylvania

• Julie Graves Moy, MD
• American Academy of Family Physicians
• Houston, Texas

• Christine Norton, MA, RN
• Director
• The Continence Foundation
• London, England

• Mary Palmer, RNC, PhD, FAAN
• Senior Staff Fellow
• National Institute of Nursing Research
• National Institutes of Health
• Baltimore, Maryland

• Richard Reed, MD
• Director, Geriatric Programs
• University of Minnesota Medical School
• Minneapolis, Minnesota

• Patricia Rowell, RN
• American Nurses Association
• Washington, DC

• Carolyn Sampselle, PhD, RN
• Associate Professor
• University of Michigan
• School of Nursing
• Ann Arbor, Michigan

• Dr. Kathleen Siegwart
• Personal Products
• Johnson & Johnson
• Dayton, New Jersey

• Stuart Smythe
• Vice President
• Laborie Medical Technologies Corporation
• South Burlington, Vermont

• Christopher Steidle, MD
• Urologist
• Northeast Indiana Urology, PC
• Fort Wayne, Indiana

• Morton A. Stenchever, MD
• Professor and Chairman
• Department of Obstetrics & Gynecology
• University of Washington School of Medicine
• Seattle, Washington

• Jim Stupar
• Incare Medical Products
• Libertyville, Illinois

• Kathe Wallace, PT
• Northlake Physical Therapy
• Seattle, Washington

• John Warren, MD
• Head, Division of Infectious Diseases
• University of Maryland School of Medicine
• Baltimore, Maryland

• Adeline Yerkes, MPH
• Chief, Chronic Disease Services
• Oklahoma State Department of Health
• Oklahoma City, Oklahoma