Urinary incontinence in old age.

Urinary incontinence is a common problem in old age, particularly among geriatric patients. Previous studies have shown an incidence of about 10% among old people in the community and about 30% among patients in nursing homes. The treatment so far has mainly been by catheter a demeure or napkins. In 1979 a study among 100 incontinent nursing home patients in Oslo was undertaken with the special intention to obtain correct classification and optimal treatment of the incontinence. The history in these cases was often misleading. Urodynamic investigations were therefore performed to obtain objective assessment. It appeared that most of the patients suffered from several conditions in their lower urinary tract which could be responsible for the incontinence. The results of treatment were acceptable as 38% of the patients became continent, 30% were improved whereas only 30% remained unchanged. It is concluded that urodynamic investigations are necessary to obtain a correct and differentiated diagnosis. If this is done appropriate treatment can be given. A plea is therefore made for using simultaneous urethrocystometry as a routine investigation in elderly patients with urinary incontinence.