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Urinary Incontinence in Elderly Men: Update on Evaluation and Treatment

  • Geriatric Urology (T Griebling, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

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.

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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

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Authors and Affiliations

  1. Department of Urology, Stanford University, 300 Pasteur Drive, Grant S-287, Stanford, CA, 94305, USA

    Raveen Syan & Craig V. Comiter

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  1. Raveen Syan
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Syan, R., Comiter, C.V. Urinary Incontinence in Elderly Men: Update on Evaluation and Treatment. Curr Geri Rep 8, 322–330 (2019). https://doi.org/10.1007/s13670-019-00308-3

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