Experience of an incontinence clinic for older women: No apparent age limit for potential physical and psychological benefits

Urinary incontinence (UI) is a common but undertreated condition in older w omen. Although a variety of noninvasive interventions is available, older w omen may be hesitant to seek care for UI because of misconceptions about no rmal aging and treatment futility. We sought to evaluate the effectiveness of a UI clinic specifically tailored to the needs of older women to promote a sense of empowerment and to enhance satisfaction with treatment and outc ome. We describe a case series of 52 women between the ages of 65 and 98 wh o were evaluated at the Geriatric Incontinence Clinic at the McGill Univers ity Health Centre over a 1-year period. A standardized telephone questionna ire was administered by a nurse consultant 6 months after each subject's fi nal visit to assess patient satisfaction and current incontinence status. F orty-five women (86%) were available for telephone follow-up and completed the questionnaire. Mean age was 80 years, with urge incontinence in 45%, mi xed incontinence (stress and urge) in 33%, impaired bladder emptying with u rge symptoms in 10%, and other diagnoses in 12%. Overall, a mean reduction of 1.4 incontinent episodes per day was reported. At follow-up, 30% of the subjects reported being cured of their incontinence, 30% had improved, 20% were the same, and 20% were worse. Over 85% of all women reported satisfact ion with their new incontinence status. Women of all ages, independent of t he type of UI, type of treatment, and cognitive status, were able to achiev e reductions in incontinence symptoms. All patients who had worsened were n oncompliant with treatment recommendations at follow-up. Older women can de rive significant benefit from a UI assessment. Neither advanced age nor cat egory of incontinence precludes improvements or enhanced satisfaction with treatment. Efforts to improve targeting and compliance may improve outcomes .