Urinary Incontinence

doi:10.1017/9781108942751.028

Chapter 28 - Urinary Incontinence

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press: 30 June 2022

Theodore M. Johnson ,

Lisa Muirhead and

Jan Busby-Whitehead

Edited by

Jan Busby-Whitehead ,

Mary H. Palmer and

Jan Busby-Whitehead: Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso: Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson: Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon: Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer: Affiliation:
University of North Carolina, Chapel Hill
William Reichel: Affiliation:
Georgetown University Medical Center

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Summary

Urinary incontinence (UI), the involuntary loss of urine, has a significant psychological, social, and economic impact on quality of life. While not an inevitable part of aging, UI is much more prevalent in older adults and particularly so in those who require assistance with activities of daily living. Patients may be reluctant to discuss UI given the associated stigma and should be asked about it during medical visits. Evaluation begins with a detailed history of the nature, severity, and burden of UI. Maintaining continence requires a complex interaction of cholinergic, adrenergic, and somatic control. A careful, directed physical exam that focuses on the abdomen, urogenital area, perineal skin, mobility, strength, reflexes, and sensation should be performed. An initial evaluation should include a urinalysis and, if renal function or polyuria is expected, blood tests for creatinine, blood urea nitrogen, glucose, and calcium. Major types of UI include urgency, stress, mixed (stress and urgency combined), and overflow UI. Absorbent products can be a useful adjunct to formal health care for helping manage leakage. Treatment modalities for UI include behavioral strategies, medication treatment, and minimally invasive procedures and surgical approaches. Older adults can have symptomatic improvements, or even cure, for this important clinical problem.

Keywords

urinary incontinence aging pelvic floor physical therapy modalities drug therapy urology gynecology quality of life activities of daily living delivery of health care

Information

Type: Chapter
Information: Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 350 - 363

DOI: https://doi.org/10.1017/9781108942751.028 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2022

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