Urinary incontinence in the disabled elderly male

A combined approach between Departments of Urology and Geriatric Medicine to the diagnosis and management of urinary incontinence in disabled elderly men with neurological lesions where outflow obstruction is thought to be a contributory factor is described. After a dual out-patient assessment, patients have a planned admission to a geriatric ward where urodynamic studies and cystoscopy are performed, followed, where necessary, by appropriate surgery. The results in 75 patients are presented. Single urodynamic studies alone are effective in establishing the diagnosis in only 20% of cases. The largest group needing surgical treatment are those with combined cerebrovascular disease and prostatic enlargement. The degree of disability, but not age, influences the outcome of surgery in such cases. The benefits of collaboration to such patients and to the departments are discussed.