Office management of urinary incontinence among older patients.

OBJECTIVE

To provide family physicians with a guide to office management of urinary incontinence (UI) among older patients.

SOURCES OF INFORMATION: Ovid MEDLINE and the Cochrane database were searched using the terms urinary incontinence, stress incontinence, overactive bladder, urge incontinence, elderly, and geriatrics.

MAIN MESSAGE: A variety of conditions affecting the nervous system and the lower urinary tract can affect bladder function and UI. Among older patients the effects of decreased cognition and impaired mobility can be substantial, and environmental barriers can play a role. When managing older patients with UI, emphasis on treating concurrent conditions, optimizing medications, and working on lifestyle and behavioural factors is at least as important as pharmacologic treatment. Medications are relevant, but the potential for adverse effects increases among older patients.

CONCLUSION

Various resources are available to support family physicians in office management of UI, and family physicians can improve symptoms and the quality of patients' lives by screening for and helping patients to manage incontinence.