Urinary incontinence evaluation and the utility of pessaries in older women

Urinary incontinence and pelvic organ prolapse are common conditions affecting the elderly. A careful evaluation of urinary incontinence, including history and physical examination, will often determine the etiology of this condition. Vaginal pessaries are a safe and efective treatment for both urinary incontinence and pelvic organ prolapse. They should be considered a viable alternative to surgery especially in the elderly with complicated medical histories. This article reviews the etiology of urinary incontinence, offers a guide in the evaluation of the incontinent woman, and reviews the use of pessaries for the treatment of incontinence and pelvic organ prolapse.