Urinary Incontinence in Older Adults

Meet the patient

A 78-year-old woman with hypertension and mild cognitive impairment leaks urine when she coughs, but also rushes to the toilet several times a night and does not always make it. She takes a morning diuretic, oxybutynin prescribed elsewhere, and is chronically constipated. She has fallen twice rushing to the bathroom at night.^[1][9]

The two questions that decide her plan are the two that decide every continence assessment: what is the mechanism? — stress, urgency, mixed, overflow, or functional — and what is making it worse? — her diuretic, her constipation, her oxybutynin, her cognition. Classify the mechanism, fix the reversible contributors, then match the therapy. That is the whole topic.^[2]

References13ShowHide

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