Skip to main content
SpringerLink
Log in

Urinary Incontinence in the Elderly

Causes and Treatment Options

  • Review Article
  • Drug Therapy
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Summary

Urinary incontinence is a prevalent and distressing condition that affects >30% of elderly individuals. A wide variety of treatment modalities is available, and can be effective in reducing or eliminating the symptoms and adverse consequences of urinary incontinence. Pharmacological therapy is an important component of the successful management of this condition, but the agents currently used do not act selectively on the lower urinary tract. Adverse effects of drug treatment are common, and are especially problematic in the elderly. A careful assessment of the type of urinary incontinence and the institution of a rational management programme are the keys to improvement or even cure in patients with this condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Herzog AR, Fultz NH. Prevalence and incidence of urinary incontinence in community-dwelling populations. J Am Geriatr Soc 1990; 38(3): 273–81

    PubMed  CAS  Google Scholar 

  2. Mohide EA. The prevalence and scope of urinary incontinence. Clin Geriatr Med 1986; 2: 639–55

    PubMed  CAS  Google Scholar 

  3. Ouslander JG, Kane RL, Abrass IB. Urinary incontinence in elderly nursing home residents. JAMA 1982; 248: 1194–8

    Article  PubMed  CAS  Google Scholar 

  4. Resnick NM, Yalla SV, Laurino E. The pathophysiology of urinary incontinence among institutionalized elderly persons. N Engl J Med 1989; 320(1): 1–7

    Article  PubMed  CAS  Google Scholar 

  5. Thomas TM, Plymat KR, Blannin J, et al. Prevalence of urinary incontinence. BMJ 1980 Nov; 281(6250): 1243–5

    Article  PubMed  CAS  Google Scholar 

  6. Hu TW. Impact of urinary incontinence on health-care costs. J Am Geriatr Soc 1990; 38(3): 292–5

    PubMed  CAS  Google Scholar 

  7. Ouslander JG, Morishita L, Blaustein J, et al. Clinical, functional, and psychosocial characteristics of an incontinent nursing home population. J Gerontol 1987; 42(6): 631–7

    PubMed  CAS  Google Scholar 

  8. Noelker LS. Incontinence in elderly cared for by family. Gerontologist 1987; 27(2): 194–200

    Article  PubMed  CAS  Google Scholar 

  9. Schnelle JF, Traughber B, Sowell VA, et al. Prompted voiding treatment of urinary incontinence in nursing home patients: a behavior management approach for nursing home staff. J Am Geriatr Soc 1989; 37(11): 1051–7

    PubMed  CAS  Google Scholar 

  10. Schnelle JF, Sowell VA, Hu TW, et al. Reduction of urinary incontinence in nursing homes: does it reduce or increase costs? J Am Geriatr Soc 1988; 36(1): 34–9

    PubMed  CAS  Google Scholar 

  11. Wein AJ. Neuromuscular dysfunction of the lower urinary tract. In: Walsh PC, Retik AB, Stamey TA, et al., editors. Campbell’s urology. 6th ed. Philadelphia: Saunders, 1992: 573–642

    Google Scholar 

  12. Fantl JA, Wyman JF, McClish DK, et al. Urinary incontinence in community-dwelling women: clinical, urodynamic and severity characteristics. Am J Obstet Gynecol 1990; 162(4): 946–51

    PubMed  CAS  Google Scholar 

  13. Abrams P, Blaivas JG, Stanton SL, et al. Standardization of terminology of lower urinary tract function. Neurourol Urodyn 1988; 7: 403–27

    Article  Google Scholar 

  14. Resnick NM, Yalla SV. Detrusor hyperactivity with impaired contractile function: an unrecognized but common cause of incontinence in elderly patients. JAMA 1987; 257: 3076–81

    Article  PubMed  CAS  Google Scholar 

  15. Staskin DR, Zimmern PE, Hadley HR, et al. The pathophysiology of stress incontinence. Urol Clin North Am 1985; 12: 271–8

    PubMed  CAS  Google Scholar 

  16. Ouslander JG, Hepps K, Raz S, et al. Genitourinary dysfunction in a geriatric outpatient population. J Am Geriatr Soc 1986; 34(7): 507–14

    PubMed  CAS  Google Scholar 

  17. William ME, Pannill III FC. Urinary incontinence in the elderly: pathophysiology, diagnosis and treatment. Ann Intern Med 1982; 97(6): 895–907

    Google Scholar 

  18. Skelly J, Flint AJ. Urinary incontinence associated with dementia. J Am Geriatr Soc 1995; 43: 286–94

    PubMed  CAS  Google Scholar 

  19. Colling J, Ouslander J, Hadley BJ, et al. The effects of patterned urge response toileting (PURT) on urinary incontinence among nursing home residents. J Am Geriatr Soc 1992; 40: 135–41

    PubMed  CAS  Google Scholar 

  20. Engel BT, Burgio LD, McCormick KA, et al. Behavioral treatment of incontinence in the long-term care setting. J Am Geriatr Soc 1990; 38: 361–3

    PubMed  CAS  Google Scholar 

  21. Schnelle JF. Treatment of urinary incontinence in nursing home patients by prompted voiding. J Am Geriatr Soc 1990; 38: 356–60

    PubMed  CAS  Google Scholar 

  22. Urinary Incontinence Panel. Urinary incontinence in adults: acute and chronic management. Clinical practice guideline. Rockville (MD): Agency for Health Care Policy and Research (AHCPR), Public Health Service, US Department of Health and Human Services 1996 Mar. AHCPR publication no.: 06-0682

    Google Scholar 

  23. Palmer MH. Urinary continence: assessment and promotion. Gaithersburg (MD): Aspen, 1996

    Google Scholar 

  24. Massey JA, Abrams P. Dose titration in clinical trials: an example using emepronium carrageenate in detrusor instability. Br J Urol 1986 Apr; 58(2): 125–8

    Article  PubMed  CAS  Google Scholar 

  25. Bagger PV, Fischer-Rasmussen W, Hansen R. Emepronium carrageenate: clinical effects and urinary excretion in treatment of female urge incontinence. Scand J Urol Nephrol 1985; 19(1): 31–5

    Article  PubMed  CAS  Google Scholar 

  26. Meyhoff HH, Gerstenberg TC, Nordling J. Placebo–the drug of choice in female motor urge incontinence? Br J Urol 1983; 55: 34–7

    Article  PubMed  CAS  Google Scholar 

  27. Walter S, Hansen J, Hansen L, et al. Urinary incontinence in old age: a controlled clinical trial of emepronium bromide. Br J Urol 1982 Jun; 54(3): 249–51

    Article  PubMed  CAS  Google Scholar 

  28. Williams AJ, Prematalake JK, Palmer RL. A trial of emepronium bromide for the treatment of urinary incontinence in the elderly mentally ill. Pharmatherapeutica 1981; 2(8): 539–42

    PubMed  CAS  Google Scholar 

  29. Yarker YE, Goa KL, Fitton A. Oxybutynin: a review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in detrusor instability. Drugs Aging 1995 Mar; 6(3): 243–62

    Article  PubMed  CAS  Google Scholar 

  30. Szonyi G, Collas DM, Ding YY, et al. Oxybutynin with bladder retraining for detrusor instability in elderly people: a randomized controlled trial. Age Ageing 1995 Jul; 24(4): 287–91

    Article  PubMed  CAS  Google Scholar 

  31. Perico A, Triolo A, Viti G, et al. Synthesis, characterization, and analytical studies of adosupine, a potential new drug for urinary incontinence. J Pharm Sci 1994 Feb; 83(2): 137–42

    Article  PubMed  CAS  Google Scholar 

  32. Norton P, Karram M, Wall LL, et al. Randomized double-blind trial of terodiline in the treatment of urge incontinence in women. Obstet Gynecol 1994 Sep; 84(3): 386–91

    PubMed  CAS  Google Scholar 

  33. Palmer JH, Worth PH, Exton-Smith AN. Flunarizine: a once-daily therapy for urinary incontinence. Lancet 1981 Aug; II(8241): 279–81

    Article  Google Scholar 

  34. Lindholm P, Lose G. Terbutaline (Bricanyl) in the treatment of female urge incontinence. Urol Int 1986; 41(2): 158–60

    Article  PubMed  CAS  Google Scholar 

  35. Taylor MC, Bates CP. A double-blind crossover trial of baclofen–a new treatment for the unstable bladder syndrome. Br J Urol 1979 Dec; 51(6): 504–5

    Article  PubMed  CAS  Google Scholar 

  36. Sereis S, Stein M. Prospective study comparing hyoscyamine, doxazosin, and combination therapy for the treatment of urgency and frequency in women. Neurourol Urodynam 1998; 17(1): 31–6

    Article  Google Scholar 

  37. Asplund R, Aberg HE. Micturition habits of older people: voiding frequency and urine volumes. Scand J Urol Nephrol 1992; 26: 345–9

    Article  PubMed  CAS  Google Scholar 

  38. Asplund R, Aberg H. Desmopressin in elderly women with increased nocturnal diuresis. J Urol 1993; 72: 42–3

    Article  CAS  Google Scholar 

  39. Asplund R, Aberg H. Desmopressin in elderly subjects with increased nocturnal diuresis: a 2-month treatment study. Scand J Urol Nephrol 1993; 27: 77–82

    Article  PubMed  CAS  Google Scholar 

  40. Seiler WO, Stahelin HB, Hefti U. Desmopressin reduces night urine volume in geriatric patients: implication for treatment of the nocturnal incontinence. Clin Investig 1992; 70: 619

    Article  PubMed  CAS  Google Scholar 

  41. Janknegt RA, Zweers HHM, Delaere KPJ, et al. Oral desmopressin as a new treatment modality for primary nocturnal enuresis in adolescents and adults: a double blind, randomized, multicenter study. J Urol 1997; 157: 413–7

    Article  Google Scholar 

  42. Lepor H, Gup DI, Baumann M, et al. Comparison of alpha 1 adrenoceptors in the prostate capsule of men with symptomatic and asymptomatic benign prostatic hyperplasia. Br J Urol 1991; 67(5): 493–8

    Article  PubMed  CAS  Google Scholar 

  43. Gormley GJ, Stoner E, Bruskewitz RC, et al. The effect of finasteride in men with prostatic hyperplasia. N Engl J Med 1992; 327: 1185–91

    Article  PubMed  CAS  Google Scholar 

  44. The Finasteride Study Group. Finasteride (MK-906) in the treatment of benign prostatic hyperplasia. Prostate 1993; 22: 291–9

    Article  Google Scholar 

  45. Lepor H, Williford WO, Barry MJ, et al. The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. N Engl J Med 1996; 335: 533–9

    Article  PubMed  CAS  Google Scholar 

  46. Boyle P, Gould AL, Roehrborn CG. Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Urology 1996; 48(3): 398–405

    Article  PubMed  CAS  Google Scholar 

  47. Walsh PC. Treatment of benign prostatic hyperplasia. N Engl J Med 1996; 335: 586–7

    Article  PubMed  CAS  Google Scholar 

  48. Narayan P, Trachtenberg J, Lepor H, et al. A dose-response study of the effect of flutamide on benign prostatic hyperplasia: results of a multicenter study. Urology 1996; 47(4): 497–504

    Article  PubMed  CAS  Google Scholar 

  49. Eri LM, Haug E, Tveter KJ. Effects on the endocrine system of long-term treatment with the non-steroidal anti-androgen Casodex in patients with benign prostatic hyperplasia. Br J Urol 1995; 75(3): 335–40

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Geriatrics and Extended Care, NHCU (11E), Amarillo VAMC, 6010 Amarillo Blvd West, Amarillo, Texas, 79106, USA

    Samer Z. Nasr

  2. Rehabilitation Research and Development Center, Atlanta Veterans Administration Medical Center, and Division of Geriatrics and Wesley Woods Geriatric Center, Emory University, Atlanta, Georgia, USA

    Joseph G. Ouslander

Authors
  1. Samer Z. Nasr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph G. Ouslander
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Samer Z. Nasr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nasr, S.Z., Ouslander, J.G. Urinary Incontinence in the Elderly. Drugs Aging 12, 349–360 (1998). https://doi.org/10.2165/00002512-199812050-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199812050-00002

Keywords

Search

Navigation