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Urinary Incontinence: Nonsurgical Treatments

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Geriatric Urology

Abstract

Nonsurgical treatments for urinary incontinence can be effective in reducing symptoms and incontinence episodes in older men and women. Behavioral interventions include toileting programs with scheduled, timed, or prompted voiding and habit or bladder training; caffeine and fluid management; pelvic floor muscle training; stress and urge reduction strategies; nocturia reduction strategies; constipation management; and functional and environmental changes. These can be selectively combined into an individualized therapeutic regimen that is recommended as first-line treatment. Devices and medication, including antimuscarinic and beta-3 adrenoreceptor agonists, alpha-blockers, and/or 5-alpha-reductase inhibitors in men and topical vaginal estrogen in women, can be added to behavioral interventions if needed to optimize efficacy. Frail older adults and those with dementia require particular caution in instituting drug therapy for incontinence.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of Pennsylvania Medical Center, 3rd Floor, West Pavilion, Perelman Center, 34th & Civic Center Blvd, Philadelphia, PA, 19312, USA

    Diane K. Newman D.N.P., F.A.A.N., B.C.B.-P.M.D.

  2. Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA

    Kathryn L. Burgio Ph.D., Alayne D. Markland D.O., M.Sc. & Patricia S. Goode M.S.N., M.D.

  3. Department of Veterans Affairs Medical Center, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC); VA Medical Center, GRECC/11G, 700 19th St S, Birmingham, AL, 35233, USA

    Kathryn L. Burgio Ph.D., Alayne D. Markland D.O., M.Sc. & Patricia S. Goode M.S.N., M.D.

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  1. Diane K. Newman D.N.P., F.A.A.N., B.C.B.-P.M.D.
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  2. Kathryn L. Burgio Ph.D.
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  3. Alayne D. Markland D.O., M.Sc.
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  4. Patricia S. Goode M.S.N., M.D.
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Correspondence to Diane K. Newman D.N.P., F.A.A.N., B.C.B.-P.M.D. .

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Editors and Affiliations

  1. Department of Urology and the Landon Center on Aging, The University of Kansas, Kansas City, Kansas, USA

    Tomas Lindor Griebling

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Newman, D.K., Burgio, K.L., Markland, A.D., Goode, P.S. (2014). Urinary Incontinence: Nonsurgical Treatments. In: Griebling, T. (eds) Geriatric Urology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9047-0_11

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