Incontinence in the elderly: objective demonstration and quantitative assessment.
Subjective and objective methods of demonstrating incontinence and assessing its severity have been compared in a group of elderly patients with a high incidence of severe urge incontinence. It was found that 24-h in-patient monitoring of urine leakage was the most sensitive method of demonstrating incontinence, with videourodynamic testing almost as good. In comparison, a 1-h pad test was poor. Visual inspection during physical examination seldom demonstrated leakage. For quantitative assessment of severity, 24-h monitoring gave the most reproducible results; it was also able to reveal significant changes in severity in response to pharmaceutical treatment. A 1-h pad test was less reproducible and suggested changes that were only poorly consistent with 24-h monitoring. The subjective responses of the patients were not useful in assessing changes in the severity of incontinence. Twenty-four hour monitoring thus stands out as a superior method of demonstrating and assessing incontinence.
Griffiths
D J
DJ
Division of Geriatrics, University of Alberta, Edmonton, Canada.
McCracken
P N
PN
Harrison
G M
GM
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008991:Monitoring, Physiologic / Q000379:methods*; D010808:Physical Examination / Q000379:methods; D013997:Time Factors; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000503:physiopathology; D014554:Urination; D014563:Urodynamics; D014741:Video Recording