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Geriatric urinary incontinence.

J G Ouslander1

  • 1Jewish Home for the Aging of Greater Los Angeles, California.

Disease-A-Month : DM
|February 1, 1992
PubMed
Summary
This summary is machine-generated.

Urinary incontinence (UI) in older adults is common and treatable. Early assessment by primary care physicians, including history, physical exam, and basic tests, is crucial for identifying and managing reversible causes of UI.

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Area of Science:

  • Geriatrics
  • Urology
  • Internal Medicine

Background:

  • Urinary incontinence (UI) is a prevalent, disruptive, and costly health issue in the geriatric population.
  • UI can stem from subacute or reversible conditions, necessitating prompt identification and management by primary care physicians.
  • Effective treatments are available, making early assessment vital for improving patient outcomes.

Purpose of the Study:

  • To outline the essential components of evaluating geriatric patients with urinary incontinence.
  • To highlight the importance of identifying and managing potentially reversible causes of UI.
  • To review available therapeutic modalities for managing urinary incontinence in the elderly.

Main Methods:

  • Initial evaluation involves a targeted history, physical examination, urinalysis, and basic lower urinary tract function tests.

Related Experiment Videos

  • Assessment focuses on identifying and managing reversible conditions like delirium and urinary tract infections (UTI).
  • Referral for further testing (urologic/gynecologic exams, urodynamics) is indicated for select patients.

    • Main Results:

    • Behavioral therapies (bladder training, pelvic muscle exercises, etc.) are effective noninvasive treatments for both community-dwelling and institutionalized older adults.
    • Pharmacologic therapies can be used adjunctively, with specific agents for stress, urge, and overflow incontinence.
    • Surgical interventions are reserved for cases with diagnosed pathologic lesions or anatomic obstruction.

    Conclusions:

    • Comprehensive assessment and management strategies, including behavioral, pharmacologic, and supportive therapies, are key to treating geriatric UI.
    • Patient and caregiver education, environmental modifications, and appropriate use of assistive devices are critical supportive measures.
    • Chronic indwelling catheterization should be a last resort, used only in specific clinical scenarios.