[Urinary and fecal incontinence in the aged from gynecologic proctologic viewpoint]

Three to four million women suffer from urinary incontinence (UI) in Germany. This number will rise further as life expectancy increases, and there is an annual incidence of newly occurring UI of about 1%. Two thirds of all women with UI suffer additional symptoms of fecal incontinence. The type of incontinence present is diagnosed on the basis of patients history, clinical findings, and functional testing. The findings should be interpreted in an age-adjusted manner to avoid over-rating (e.g. urethral closure pressure at rest=100-age in cm H(2)O). The management of elderly patients focuses on conservative approaches with bladder and intestinal training as well as dietary measures serving to counteract the age-related loss of intellectual abilities. Local estrogen application has a positive effect on all forms of incontinence. Surgical approaches aim at improving symptoms since forced restoration of incontinence in elderly patients frequently induces voiding disorders.