Voiding Problems and Urinary Incontinence in the Geriatric Patient

Urinary incontinence (UI) is defined as the involuntary loss of urine. It is common, under-reported, and morbid. More so in older adults than in younger adults, urinary incontinence may be multifactorial and is therefore considered among geriatric syndromes. For this reason, typical clinical symptom-based approaches may be subeffective and potentially harmful. In this chapter, we approach the problem by proposing that understanding incontinence first requires understanding the determinants of social urinary continence. Unlike standard bladder-centric clinical approaches, incontinence extends beyond the aging lower urinary tract. Urinary incontinence rarely occurs as an isolated problem in older patients. Considerations are proposed to help identify the factors that contribute to incontinence in the individual patient, and patient-center approaches to managing bladder control disorders in older adults are reviewed.