Urinary incontinence

BACKGROUND: One of the more prevalent conditions associated with aging in u rinary incontinence (UI), which may affect up to 55% of women and 34% of me n older than 65 years. As a result of increasing longevity in developed nat ions, the proportion of UI-susceptible individuals continues to grow, prese nting clinical and economic challenges to healthcare providers. OBJECTIVE: To assist the clinician in making informed decisions regarding U I, provide information on the wider ramifications of the disease, and provi de a comprehensive overview of the condition. DATA SOURCES: MEDLINE (1966-December 1998) was searched for relevant public ations using the following search terms: UI, UI in the elderly, treatment o f UI, oxybutynin, flavoxate, vasopressin, quality of life in UI, and econom ic impact of UI. DATA SYNTHESIS: Key articles relating to the etiology, diagnosis, classific ation, economic burden, quality of life, and treatment of UI were retrieved , and this information formed the basis of the review. CONCLUSIONS: Although UI can be controlled relatively well with existing th erapies, only about 50% of affected patients may actually seek care. There are a variety of therapeutic options available for the treatment of UI, alt hough pharmacologic intervention is presently a relatively minor component of overall care; this suggests that effective drug therapy might play a mor e significant role in the future. The economic burden associated with the c are of the incontinent patient is substantial, and in the US the direct med ical cost of the disease was estimated at $25.5 billion in 1995. The diseas e also has a large impact on the individual UI patient negatively affecting many parameters normally associated with a tolerable health-related qualit y of life.