Urinary incontinence in a large psychiatric hospital

Of 792 patients resident in a large psychiatric hospital 266 (33.6%) were found to be incontinent of urine and 243 of these patients were reported on. Of these, 154 (63.4%) were also incontinent of faeces. A majority of patients experienced urinary incontinence regularly day and night and the amount of wetting was usually very considerable. The symptoms identified indicated a mixture of aetiological factors, but physical disability appeared to play an important role. Evidence of inefficient bladder emptying was found in 46% of patients tested. A similar proportion of patients who were X-rayed were found to have colonic faecal stasis. Strategies for managing this very large problem were not well developed. Lack of attention to the symptoms of urinary and faecal incontinence will compromise the ability of residents of large psychiatric hospitals to be settled in the community.