[Federal Register Volume 72, Number 141 (Tuesday, July 24, 2007)]
[Notices]
[Pages 40316-40317]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-14208]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health


State-of-the-Science Conference: Prevention of Fecal and Urinary 
Incontinence in Adults; Notice

    Notice is hereby given of the National Institutes of Health (NIH) 
``State-of-the-Science Conference: Prevention of Fecal and Urinary 
Incontinence in Adults'' to be held December 10-12, 2007, in the NIH 
Natcher Conference Center, 45 Center Drive, Bethesda, Maryland 20892. 
The conference will begin at 8:30 a.m. on December 10 and 11, and at 9 
a.m. on December 12, and will be open to the public.
    Fecal and urinary incontinence--the inability to control bowel 
movements or urination, respectively--are conditions with ramifications 
that extend well beyond their physical manifestations. Many people find 
themselves withdrawing from their social lives and attempting to hide 
the problem from their families, friends, and even their doctors. The 
embarrassing nature of these conditions poses a significant barrier to 
seeking professional treatment, resulting in a large number of 
unreported, untreated individuals. Therefore, it is difficult to 
determine the accurate prevalence of these conditions, as well as any 
associated medical history trends. Incontinence is more likely to 
affect the aging population, although it is not considered a normal 
consequence of aging. As baby boomers approach their 60s, the incidence 
and public health burden of incontinence are likely to increase.
    Fecal incontinence is a serious and embarrassing problem that 
affects up to 5 percent of the general population and up to 39 percent 
of nursing home residents. It affects people of all ages but is more 
common in women and the elderly. Bowel function is controlled by three 
factors: rectal sensation, rectal storage capacity, and anal sphincter 
pressure. If any of these are compromised, fecal incontinence can 
occur. This condition can have many causes, including constipation, 
diarrhea, complicated childbirth, muscular or nerve damage, reduced 
storage capacity due to scarring or irritation, or pelvic dysfunction.
    Although urinary incontinence can affect people at all stages of 
life, it has been estimated that urinary incontinence affects 38 
percent of women and 17 percent of men 60 years of age and older. 
Urinary incontinence can occur if muscles in the wall of the bladder 
suddenly contract or if muscles surrounding the urethra suddenly relax. 
Women who have undergone childbirth are the most commonly associated 
at-risk population for urinary incontinence. Pregnancy and delivery can 
weaken pelvic muscles, and reduced levels of the hormone estrogen 
following menopause can cause reduced muscle tone around the urethra, 
increasing the chance of leakage. Additionally, neurologic injury, 
birth defects, strokes, multiple sclerosis, and physical problems 
associated with aging have been reported to contribute.
    Because incontinence is likely widely underdiagnosed and 
underreported, it has been difficult to identify both at-risk and 
affected populations. Also, because the biological mechanisms that 
cause both fecal and urinary incontinence are not well understood, it 
has been difficult to develop robust prevention and management 
strategies. Toward that end, the National Institute of Diabetes and 
Digestive and Kidney Diseases and the Office of Medical Applications of 
Research of the NIH will convene a State-of-the-Science Conference from 
December 10 to 12, 2007, to assess the available scientific evidence 
relevant to the following questions:
     What are the prevalence, incidence, and natural history of 
fecal and urinary incontinence in the community and long-term care 
settings?
     What is the burden of illness and impact of fecal and 
urinary incontinence on the individual and society?
     What are the risk factors for fecal and urinary 
incontinence?
     What can be done to prevent fecal and urinary 
incontinence?
     What are the strategies to improve the identification of 
persons at risk and patients who have fecal and urinary incontinence?
     What are the research priorities in reducing the burden of 
illness in these conditions?
    An impartial, independent panel will be charged with reviewing the 
available published literature in advance of the conference, including 
a systematic literature review commissioned through the Agency for 
Healthcare Research and Quality. The first day and a half of the 
conference will consist of presentations by expert researchers and 
practitioners and open public discussions. On Wednesday, December 12, 
the panel will present a statement of its collective assessment of the 
evidence to answer each of the questions above. The panel will also 
hold a press conference to address questions from the media. The draft 
statement will be published online later that day, and the final 
version will be released approximately six weeks later. The primary 
sponsors of this meeting are the National Institute of Diabetes and 
Digestive and Kidney Diseases and the NIH Office of Medical 
Applications of Research.
    Advance information about the conference and conference 
registration materials may be obtained from American Institutes for 
Research of Silver Spring, Maryland, by calling 888-644-2667, or by 
sending e-mail to [email protected]. American Institutes for 
Research's mailing address is 10720 Columbia Pike, Silver Spring, MD 
20901. Registration information is also available on the NIH Consensus 
Development Program Web site at http://consensus.nih.gov.


    Please Note: The NIH has instituted security measures to ensure 
the safety of NIH employees and property. All visitors must be 
prepared to show a photo ID upon request. Visitors may be required 
to pass through a metal detector and have bags, backpacks, or

[[Page 40317]]

purses inspected or x-rayed as they enter NIH buildings. For more 
information about the new security measures at NIH, please visit the 
Web site at http://www.nih.gov/about/visitorsecurity.htm.


    Dated: July 12, 2007.
Raynard S. Kington,
Deputy Director, National Institutes of Health.
 [FR Doc. E7-14208 Filed 7-23-07; 8:45 am]
BILLING CODE 4140-01-P