The prevalence and severity of urinary incontinence in women

Prevalence and outcome of low ADL and incontinence among the elderly: five years follow-up in a Japanese urban community

Activities of daily living (ADL) and state of incontinence in 2,567 elderly community residents aged 65 years and over, living in Koganei City (a suburb of Tokyo) were longitudinally investigated through two mail surveys at the beginning and end of a five-year period. At the entry, only 6% of total subjects were classified as low ADL, 3% as incontinent. 30% of the low ADL were classified as incontinent. While the majority of the high ADL and the non-incontinent subjects maintained their conditions during the 5-year period, 66% of the low ADL, 70% of the incontinent, and 81% of the low ADL accompanied by incontinence died during the 5-year period. These mortality rates in low ADL and/or incontinent subjects were 2 times higher than the age-sex standardized mortality rate in the population investigated.

Obscuring urinary incontinence. Diapering of the elderly

To assess the prevalence, evaluation, and treatment of urinary incontinence in an institutionalized elderly population, the charts of 511 residents in a New York City nursing home were reviewed. Whereas the nurses' notes documented urinary incontinence in 62.4% of the total resident population, the physicians' notes listed this as a problem in only 10% of the residents. Most (90.3%) of the cases of incontinence were not classified as to etiology or pattern. Treatment emphasized the use of diapers in 78.2% of the cases, which was combined with bladder conditioning in most instances. This treatment approach had been initiated, administered, and monitored by the nursing staff. Indwelling catheters were used in 4.0% of the situations, and pharmacologic therapy was used in 2.5% of the cases. It is suggested that adult diapers may not be the optimal treatment for urinary incontinence since they treat the symptom instead of the cause. There should be a systematic approach to the classification and treatment of urinary incontinence prior to the long-term utilization of diapers.

The epidemiology of urethral-vesical dysfunction in the female patient

The specific purposes of this report are twofold: (1) to summarize the descriptive epidemiology of urethral-vesical dysfunction in a population of 1439 female patients referred for urodynamic evaluation of symptoms and (2) to analyze the association between demographic, clinical, and investigative data. On the basis of urodynamic studies, abnormalities were classified into four types: anatomic dysfunction, 60%; neuromuscular dysfunction, 20%; neuropathic dysfunction, 12%; and miscellaneous dysfunction, 8%. Analyses and cross tabulations of clinical data vis-à-vis investigative studies reveal poor correlation between subjective clinical data and urodynamic diagnoses. The clinical symptoms of urethral-vesical dysfunction in the female patient may be confusing and complex. Urodynamic evaluation of symptoms and clinical data is of value in the design of a rational therapeutic program for such patients.