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Urinary Incontinence in Elderly Men: Update on Evaluation and Treatment

  • Raveen SyanEmail author
  • Craig V. Comiter
Geriatric Urology (T Griebling, Section Editor)
  • 4 Downloads
Part of the following topical collections:
  1. Topical Collection on Geriatric Urology

Abstract

Purpose of Review

To provide an overview of the appropriate evaluation of elderly men with urinary incontinence and an updated review of treatment options available to these patients.

Recent Findings

Adding pelvic floor physical therapy to bladder training exercises is more effective for treating overactive bladder than bladder training alone. Beta-3 adrenergic agonists are a safe and effective alternative to anticholinergic therapy in older adults. Sacral neuromodulation is safe and effective in older adults and may benefit men with incomplete bladder emptying. A de-obstructing surgery may benefit men with both underactive bladder and bladder outlet obstruction, given that a majority will recover detrusor function following intervention. In post prostatectomy incontinence, the artificial urinary sphincter is more effective in men with moderate to severe incontinence, though it is associated with a higher rate of complications.

Summary

Many options are available to the elderly male patient with urinary incontinence. Careful consideration of patient’s functional status, frailty, mental health status, and social support systems are needed to guide the appropriate treatment options.

Keywords

Geriatric urology Urinary incontinence Elderly incontinence Urinary incontinence treatment Urinary incontinence evaluation 

Abbreviations

ADLs

Activities of daily living

AUS

Artificial urinary sphincter

BOO

Bladder outlet obstruction

BPH

Benign prostatic hyperplasia

OAB

Overactive bladder

PPI

Post prostatectomy incontinence

PTNS

Percutaneous tibial nerve stimulation

PVR

Post void residual

SNS

Sacral neuromodulation

SUI

Stress urinary incontinence

TURP

Transurethral resection of prostate cancer

UDS

Urodynamics study

UI

Urinary incontinence

UUI

Urge incontinence

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyStanford UniversityStanfordUSA

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