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[Guidelines concerning urinary incontinence in elderly: construction and validation of GRAPPPA algorithm]
G Amarenco1, X Gamé2, A-C Petit3
1Service de neuro-urologie, hôpital Tenon, AP-HP, GRC01 UPMC GREEN, 4, rue de la Chine, 75020 Paris, France.
Summary
This study introduces an algorithm for evaluating and treating urinary incontinence in older adults. The GRAPPPA algorithm guides initial assessment and recommends first-line therapies like pelvic floor training for better patient outcomes.
Area of Science:
- Gerontology
- Urology
- Geriatric Medicine
Background:
- Urinary incontinence is a prevalent issue in the elderly population, significantly impacting quality of life.
- Current management strategies often lack a standardized approach for evaluation and first-line therapy in this demographic.
Purpose of the Study:
- To present an algorithm for the practical evaluation and first-line therapy of urinary incontinence in elderly individuals.
- To establish evidence-based guidelines for managing different types of incontinence in older patients.
Main Methods:
- Development of guidelines using a formalized consensus method with a panel of 40 multidisciplinary experts.
- Validation of proposed guidelines through multiple rounds of expert interrogation and review.
Main Results:
- Construction of the GRAPPPA algorithm, integrating evaluation and first-line therapeutic options for urge, stress, and mixed urinary incontinence.
- Key initial evaluation steps include screening for urinary retention, fecal impaction, anticholinergic/morphinic drug use, UTIs, and cognitive impairment.
- First-line therapies universally include pelvic floor training, local estrogen therapy, and dietary modifications; anticholinergics are an option for urge incontinence.
Conclusions:
- Implementation of the GRAPPPA algorithm can standardize and improve the management of urinary incontinence in the elderly.
- This algorithmic approach aims to promote best practices in geriatric urological care.
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