Urinary Incontinence

Question 1

Is urinary incontinence a normal part of ageing?

Answer 1

No

You should treat it if an elderly person presents with it!

Question 2

As someone ages the bladder capacity and urethral closure pressure ______1______

The post void residual volume and detrusor overactivity ____2______

Answer 2

1) decrease

2) increase

Question 3

Explain what functional incontinence is?

Answer 3

important type in elderly

incontinence resulting from an inability to reach or use the toilet in time e.g. poor mobility or cognitive impairment

Question 4

What treatment can you consider specifically for nocturia?

Answer 4

late afternoon diuretic

desmopressin (although this is contraindicated in hypertension or heart disease and can cause hyponatraemia)

Question 5

What treatment can you give specifically for atrophic vaginitis?

Answer 5

local intravaginal oestrogens can make a significant difference and are fairly side effect free

Question 6

If someone has significant post void residual volume what should you do?

Answer 6

consider

1) constipation and treat if appropriate
2) in males consider BPH which can be treated with alpha blockers e.g. alfuzosin or 5 alpha reductase inhibitors e.g. finasteride