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Bladder and Bowel Continence in Older Women

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Challenges in Older Women’s Health

Abstract

More than 60% of women over age 65 living independently experience bladder and/or bowel incontinence, and the prevalence among institutionalized older adults is even higher. While its impact on quality of life cannot be overstated, incontinence is also associated with social isolation, depression, falls, and institutionalization. A thorough history, medication review, and physical exam are the most important components of the evaluation of incontinence symptoms. Urinary incontinence may be associated with activity (stress incontinence), urgency (urge incontinence), or both (mixed). Bowel incontinence may be without awareness (passive) or urge-associated, and may depend on stool consistency. Constipation may result in overflow bowel incontinence. Initial treatment recommendations include behavior modifications and pelvic floor muscle training for most women with bladder or bowel incontinence. Additional treatment options vary based on symptoms and may include bladder re-training, biofeedback, fiber supplementation, medication, rectal or vaginal inserts (including pessaries), nerve stimulation therapy, or surgery. Despite the existence of effective solutions, most women with incontinence do not discuss their symptoms with a healthcare provider due to existing stigma. It is therefore imperative that medical providers screen for incontinence routinely and provide counsel that while incontinence is a common condition with aging, it is always abnormal, and there are effective solutions to improve symptoms.

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Author information

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Heidi W. Brown & Angela L. Sergeant

  2. Division of Female Pelvic Health, Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA

    Candace Parker-Autry

Authors
  1. Heidi W. Brown
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  2. Candace Parker-Autry
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  3. Angela L. Sergeant
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Corresponding author

Correspondence to Heidi W. Brown .

Editor information

Editors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA

    Heidi W. Brown

  2. Division of Academic Specialists in Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA

    Makeba Williams

  3. Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA

    Sarina Schrager

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Brown, H.W., Parker-Autry, C., Sergeant, A.L. (2021). Bladder and Bowel Continence in Older Women. In: Brown, H.W., Williams, M., Schrager, S. (eds) Challenges in Older Women’s Health. Springer, Cham. https://doi.org/10.1007/978-3-030-59058-1_11

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  • DOI: https://doi.org/10.1007/978-3-030-59058-1_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-59057-4

  • Online ISBN: 978-3-030-59058-1

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