[Physiotherapy in the treatment of urinary incontinence in elderly women].

Urinary incontinence is defined as involuntary loss of urine that is demonstrable objectively and constitutes a social/hygienic problem. Urinary incontinence can affect both men and women at different ages. It is more prevalent, however, in women, and may be considered a greater problem in the elderly, who may also have other problems, such as difficulty in walking, and generally impaired capacity for the activities of daily living. In a Norwegian study, 27% of the women aged 74-75 years who lived at home, were found to have urinary incontinence. Studies from other countries have shown a prevalence of 30% in patients in hospitals and 50-70% in nursing homes. Randomized controlled trials have shown a positive effect of pelvic floor muscle exercise in women with stress incontinence. Some researchers have found a negative association between age and response to treatment, but this is contradicted by results from other studies. Few randomized controlled studies have evaluated the effect of pelvic floor muscle exercise alone or in combination with bladder training in elderly women. However, the results from two controlled studies and other uncontrolled trials show a potentially high effect of physiotherapy to treat urinary incontinence in elderly women. More controlled randomized studies are needed using reliable and valid outcome measures to evaluate each method of physiotherapy separately. Both bladder training and pelvic floor muscle exercises have no known side effects and can be recommended for today's elderly population.