BACKGROUND: Urinary incontinence (UI) is a problem that affects women of all ages. Research has identified many risk factors for the development of UI but is inconclusive regarding the relationship between episiotomy and hysterectomy and the development of UI symptoms. Physical therapists are emerging as primary care providers which increases the importance of attention to and knowledge of risk factors facilitate timely screening and care for women at risk or who have UI signs and symptoms. PURPOSE: The purpose of this study was to examine the relationship between episiotomy and hysterectomy and incidence of urinary incontinence. SUBJECTS: The subjects included the female patient population of a local women's health care clinic, and female faculty and staff of a small university community. METHODS: Information was gathered using a survey from 2 cluster samples. Information included age, parity, history of episiotomy and/or hysterectomy, type and symptoms of incontinence, treatment received, the woman's perception of treatment success, and medications prescribed. ANALYSES: Analyses was done separately for the 2 cluster samples. Means and standard deviations were calculated for weight and parity status. Frequencies of response to all other questions were calculated. Comparisons between those who had surgical procedures and those who did not were done using a Chi square. Data was considered significant if at p < 0.05. RESULTS: The data from the 2 cluster samples were analyzed and are presented separately. Two hundred thirty three surveys were completed by one group and 73 from the other group. Combining the surveys, 18% (n=55) reported the presence of incontinence, however, 77% (n=236) reported one or more symptoms of incontinence. For all the respondents, there was a significant difference between the incidence of incontinence for the women who had the surgical procedures of episiotomy (p < .003) and hysterectomy (p < .001), and those who did not have surgeries. CONCLUSION: Among the women in our study there was a significant association between the incidence of UI and history of either episiotomy or hysterectomy. An important finding, not related to the original intent ofthe study, was that a high percentage of women have symptoms of UI, while not reporting that they have UI. Whether this is from lack of information regarding what UI is, or from a desire not to be classified as having UI, the resultant difference in frequency was significant and should be considered by clinicians in they way they ask specific questions.