[Urinary incontinence in geriatric patients: Continence products, specialized continence nurses and indwelling...

1/2019 we presented an update of the AWMF guideline 'urinary incontinence in frail elderly - diagnostics and therapy'. Since its introduction in 2015 the guideline has been under a continuous revision process by the working group 'Incontinence' of the German Society for Geriatrics (DGG). From this guideline which is accredited as an official guideline of the DGG we present here the chapter about continence products, specialized continence nurses and indwelling catheter.

A profound literature search was done in a structured evaluation process in the context of a 'frail elderly'. Most medical societies define a 'frail elderly' as someone older than 70 years and multimorbide or older than 80y. We focused on randomized, double blind, placebo controlled studies as well as already published guidelines in this field. In the case no studies were available or not feasible other publications such as not randomized studies or case reports were taken into consideration for our guideline. Recommendations resulted from a structured voting process and the results are stated as percentage of members who agreed.

In case of failed or not wanted incontinence treatment, options like an indwelling transurethral or suprapubic catheter or a condom catheter in men maybe the best transient or definite solution. Trained specialized continence nurses have proven to be beneficial in conservative treatment modalities, such as toilet training or measuring residual urine. They can further consult patients and carers to enhance physical environment to reduce incontinence.

Especially in institutions caring for frail elderly a coordinated care of specialized a multidisciplinary setting of continence nurses and doctors are beneficial for those affected. Under certain conditions palliative treatment should be included in geriatric incontinence care.