Urinary incontinence in the elderly.

Transient urinary incontinence in an elderly person is often due to a potentially reversible factor that can be recognized and corrected by the primary care physician. The cause of established incontinence may also be found after office evaluation. Treatment may include bladder retraining, use of an anticholinergic or alpha-adrenergic drug, and/or surgery. Referral to a specialist may be indicated. In many elderly patients, no cause for incontinence is apparent even after careful examination of the patient. Management in this case is controversial: The patient may be referred for further evaluation or treated empirically for presumed uninhibited neurogenic bladder. In some situations, incontinence can be managed only by the use of a bedpan or special garments or, as a last resort, catheterization.