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Related Experiment Videos

Intractable incontinence in the elderly.

J G Ouslander1

  • 1Division of Geriatric Medicine and Gerontology, Wesley Woods Center of Emory University, Atlanta, Georgia, USA.

BJU International
|April 17, 2002
PubMed
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Urinary incontinence management in the elderly requires a thorough assessment to identify reversible causes. Focus on improving quality of life and preventing complications, rather than solely aiming for a cure.

Area of Science:

  • Gerontology
  • Urology
  • Geriatric Medicine

Background:

  • The global population of individuals aged over 75 is rapidly increasing.
  • Urinary incontinence (UI) is a common condition in the elderly, significantly impacting quality of life.
  • Cognitive and mobility impairments in this demographic complicate UI assessment and management.

Purpose of the Study:

  • To outline a comprehensive approach to assessing and managing urinary incontinence in the elderly population.
  • To emphasize achievable goals such as improved quality of life and prevention of secondary complications over complete cure.
  • To guide clinicians in determining appropriate interventions, from non-invasive therapies to surgical options.

Main Methods:

  • Initial assessment to identify potentially reversible causes of incontinence.

Related Experiment Videos

  • Trial of non-invasive therapies, including behavioral (e.g., prompted voiding) and pharmacological (e.g., bladder relaxants) interventions.
  • Consideration of surgical interventions based on patient's ability, willingness, and preferences.
  • Judicious use of containment products (pads/garments) and indwelling catheters, avoiding dependency and risks.

    • Main Results:

    • A basic assessment can identify reversible causes and guide further evaluation for elderly incontinent individuals.
    • Non-invasive therapies, particularly prompted voiding and judicious use of bladder relaxants, are effective for many frail elderly.
    • Focusing on relief, functional improvement, and quality of life is more realistic and beneficial than aiming for cure.
    • Careful management prevents secondary morbidities like urinary tract infections and sepsis.

    Conclusions:

    • Urinary incontinence in the elderly, especially those with cognitive or mobility issues, requires a tailored management strategy.
    • Non-invasive treatments should be prioritized before considering more invasive options.
    • The primary goals should be to improve quality of life, enhance function, and prevent complications, recognizing that cure is often not feasible.