Urinary incontinence: Keys to diagnosis of the older woman - Part One of aroundtable discussion

Up to 38% of women age 65 and older experience urinary incontinence to some degree, although the prevalence in this population may be even greater Agi ng, childbirth, and hormonal changes affect the muscle and tissue support o f the urethra and bladder decreasing their ability to hold urine. Neurologi c injury related to disease, trauma, or surgery may impair the pathways bet ween the brain and bladder, leading to inappropriate urgency and frequency. Older women often do not talk about their incontinence, because they are e mbarrassed or believe there is no cure. Therefore, it's important for clini cians to ask about the involuntary loss of urine, A careful history alone c an often reveal 80 to 90% of the diagnosis.