LAUSR

Standardized terminology is vital to communication as well as the efficacy of clinical practice and research in medicine. To create that terminology, appropriate well‐ recognized, and accepted Societies in any field of medicine call for the election of experts of appropriate reputational stature and experience into a Working Group (WG) for a specific subject. The challenge of terminology documents is to achieve clarity of definitions. It was very difficult with a recently published Editorial on Joint Terminology Documents, entitled “Joint terminology documents: are there too many or is this the way forward,” to determine a clearly defined message. Too many or too few such documents, as one might glean from the title, might be seen as an “each‐ way bet.” Unfortunately, neither bet is a winner. It is not a question of the number of such documents, as suggested in the Editorial: it is a question of a justifiable need to produce a specific document. It is, of course, also a question of quality: are the Societies and “experts” of appropriate reputational stature and experience and the processes of sufficient rigor? We will attempt to provide a clearly defined message on Joint Terminology Documents. Terminology documents are created when there is a clear justification to either cover or update a certain area of knowledge. Urogynaecology is blessed to have had enormously wide coverage of definitions, as comprehensive as any field of medicine or surgery, gradually being updated over 25 years. Alternate terminology involves groups ignoring the history of the involved terminology to produce new definitions from “left field.” The choice to involve multiples Societies generally relates to the politics of the time. The more the Societies included, the more time‐consuming, political, and, at times, chaotic, the document development process is likely to be due to multiple Society‐Board input. Any Societies which are “new” to Terminology and Standardization, might not be used to the processes for achieving a quality outcome. International Continence Society (ICS) Terminology history dates back to 1972 (Chair: Tage Hald); International Urogynecological Association Terminology history dates back to 2000 (Chair: Harold Drutz). The history of Joint Terminology documents commenced in 1996 (not 2010) with the original pelvic organ prolapse (POP) document (ICS‐AUGS‐SGS), with POP terminology updated in 2002 (ICS), 2010 (IUGA‐ICS), and 2016 (IUGA‐ICS). The 2010 International Urogynecological Association (IUGA) ‐ ICS Female Pelvic Floor Dysfunction document was the first comprehensive terminology document for women with the 2016 IUGA‐ICS document again POP‐oriented. A total of eight ICS‐IUGA terminology projects have been published5–12 on needful and varied subjects (late withdrawal of IUGA from Reference 12). All the terms and descriptors in these documents have been uploaded to the ICS Glossary —(https://www.ics.org/glossary) in an ongoing and very orderly process. We do not understand the author's comment “we are constantly bombarded with the next joint terminology document.” Is the Letter's author, as an Editor on the International Urogynecology Journal (IUJ) receiving other terminology offerings which are non‐ICS‐ IUGA, also of possible questionable quality? The concern “does anyone read these documents” can be answered with the high to the very high number of current citations for Joint Terminology documents: (Reference 3: 4623; Reference 5: 3980; Reference 6: 880; Reference 7: 631, Reference 11: 312), let alone the indeterminate, but probably much higher, number of “reads.” The impact factors of the relevant Journals, IUJ and Neurourology and Urodynamics (NAU), as suggested, have certainly risen significantly from Joint Publications. The ICS Glossary has had an average of 5765 “Unique page views” (sessional visits) each month in 2021 (this does not include multiple visits in the same session). The Glossary remains an invaluable reference for authors and reviewers to determine if appropriate and accurate Terminology is being used in publications. There are no “terminology documents” that are not utilized, nor should any documents be “retired” as they allow readers to review terminology history and subtle changes and extensions to the body of definitions. There can be no argument on the “usefulness of such documents” as there can be no argument on the usefulness of an updated medical or general dictionary. The terminology documents (male, female, and general) are already cataloged chronologically in the ICS Glossary, noting the latest reference for a particular definition with earlier references also listed.