Urinary incontinence volume patterns in elderly inpatient men

Urinary incontinence is a costly and debilitating disease of the aged. Although the most common clinical finding is detrusor hyperreflexia on filling cystometry, the role of this urodynamic abnormality in the etiology of incontinence is uncertain. The purpose of this study was to evaluate elderly patients who have cystometric detrusor hyperreflexia and to determine the incontinence volume characteristics of these patients during regular daily activities. Ten patients with detrusor hyperreflexia during filling cystometry and an incontinence volume level above 1 L per day were evaluated according to the volume of urine loss per incontinence episode during a ten-day measurement period. All patients studied were found to have an irregular urinary incontinence volume distribution with a wide range of involuntary urine loss per incontinence episode. An irregular pattern of incontinence volume was found in each patient which suggests that detrusor hyperreflexia is manifest as an irregular involuntary loss of urine during daily activities of elderly inpatients. This unstable bladder activity relative to the volume of urine loss appears to be an important factor in the pathophysiology of urinary incontinence in aged inpatients.