Ph6,f and i A n d r e w Fantl, MDSoss of urinary control can have a sigmficant impact on the psychological and social well-being of the affected individual. Research has con-L centrated on the prevalence, etiology, and management of urinary incontinence, but relatively little is known about the effects of this chronic condition on psychosocial functioning in daily life.This article reviews the literature related to psychosoaal impact of urinary incontinence in the communitydwelling adult population. The focus is on the individual with incontinence who is otherwise healthy, mentally intact, and residing independently in the community. Issues related to the definition and measurement of psychosocial impact are discussed. Relevant research findings are presented on the type and degree of psychosocial effects resulting from incontinence, differences in impact related to the underlying etiology of incontinence, and the relationship of psychosocial impact to severity measures of urinary incontinence. Recommendations for future research are also proposed. DEFINITION AND MEASUREMENT OF PSYCHOSOCIAL IMPACTUrinary incontinence has been defined as a "condition of involuntary urine loss that is a social or hygienic problem and is objectively demonstrable."' Although much attention has been focused on the objective measurements of urinary incontinence, what constitutes a "social or hygienic" problem has not been clearly characterized or defined in operational terms.Studies reporting psychosocial impact of inconti-

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