Urinary incontinence in the elderly

Although often unreported, urinary incontinence is a common problem confronting primary care physicians caring for the elderly. Most patients with urinary incontinence can be cured or improved through proper diagnosis and management. Many incontinent patients can be treated based on history, physical examination, and simple laboratory and bedside testing. Efforts are currently underway to determine the best method for selecting patients who require referral for urologic evaluation and urodynamic testing. Behavioral therapy, drugs, and surgery, alone or in combination, will result in marked improvement for many patients. For others, careful attention to environmental support may minimize the impact of incontinence. An optimistic and enthusiastic attitude on the part of the treating physician is important in improving patient compliance with long-term therapy.