Volume 70 Number 1 January 2003	back to contents

¹Chief Resident and ²Clinical Associate Professor and Director of Voiding Dysfunction, Department of Urology, Mount Sinai School of Medicine, New York, NY.

Address all correspondence to Jonathan M. Vapnek, M.D., Department of Urology, Box 1272, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029.

This work is based on a presentation at the Geriatric Medicine Update and Board Review at the Mount Sinai School of Medicine, New York, NY on October 5–8, 2001.

ABSTRACT

BACKGROUND: Urinary incontinence is a widespread, yet potentially treatable, problem in the geriatric population.

METHODS: We reviewed the geriatric and urologic literature to provide an update on the definition, diagnosis, and treatment of geriatric urinary incontinence.

RESULTS: Urinary incontinence affects 15–30% of elderly individuals in the community and 50% of those living in nursing homes. Both age and gender affect bladder function, and incontinence affects females and males in a ratio of 2:1. Incontinence can be classified as urge, stress, overflow, functional, or mixed. There are many reversible causes of incontinence, and a thorough history and physical examination, including a complete voiding history and a tailored neuro-urologic examination, are required for accurate diagnosis. Treatment options include behavioral modification, medical therapy with anticholinergics or hormone replacement, and surgical intervention.

CONCLUSIONS: Urinary incontinence, due to many causes, is a widespread problem among the elderly. Yet many of these causes are reversible with appropriate treatment, often by the primary care provider. Some patients may require urologic referral for sophisticated urodynamic studies and possible surgical intervention, in select cases.

KEYWORDS

Incontinence, voiding dysfunction, geriatric.

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