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Urinary incontinence in elderly women: urodynamic evaluation
A C Diokno1, T J Wells, C A Brink
1William Beaumont Hospital, Royal Oak, Michigan.
Journal of the American Geriatrics Society
|October 1, 1987
Summary
This study evaluated urinary incontinence in women aged 55+, finding an incompetent urethra in 77%. Urodynamic testing is crucial for accurate diagnosis, especially for stress incontinence.
Area of Science:
- Gerontology
- Urology
- Gynecology
Background:
- Urinary incontinence (UI) is a prevalent condition affecting elderly women.
- Accurate diagnosis is essential for effective management of UI.
Purpose of the Study:
- To characterize urinary incontinence in elderly women.
- To assess the diagnostic importance of various urodynamic parameters for UI.
Main Methods:
- A cohort of 200 ambulatory, incontinent women aged 55+ underwent medical history, physical examination, and urodynamic testing.
- Urodynamic tests included simple provocative stress tests and upright cystometry.
Main Results:
- 77% of women had an incompetent urethra, 25% had a hyperactive bladder.
- Clinical diagnosis accuracy for stress incontinence was 78%, but only 44% for urge incontinence.
- Simple provocative tests effectively detected stress UI; upright cystometry identified additional hyperactive bladders.
Conclusions:
- Urodynamic testing is vital for diagnosing UI in elderly women, particularly for differentiating stress and urge incontinence.
- Simple, provocative urodynamic maneuvers are effective for common UI types.
- Complex urodynamic evaluations are best reserved for complex or unexplained cases.