Urinary incontinence in the geriatric population

Background: Urinary incontinence is a widespread, yet potentially treatable, problem in the geriatric population. Methods: We reviewed the geriatric and urologic literature to provide an update on the definition, diagnosis, and treatment of geriatric urinary incontinence. Results: Urinary incontinence affects 15-30% of elderly individuals in the community and 50% of those living in nursing homes. Both age and gender affect bladder function, and incontinence affects females and males in a ratio of 2:1. Incontinence can be classified as urge, stress, overflow, functional, or mixed. There are many reversible causes of incontinence, and a thorough history and physical examination, including a complete voiding history and a tailored neurourologic examination, are required for accurate diagnosis. Treatment options include behavioral modification, medical therapy with anticholinergics or hormone replacement, and surgical intervention. Conclusions: Urinary incontinence, due to many causes, is a widespread problem among the elderly. Yet many of these causes are reversible with appropriate treatment, often by the primary care provider. Some patients may require urologic referral for sophisticated urodynamic studies and possible surgical intervention, in select cases.