Urinary incontinence in elderly women: clinical findings.
Two-hundred women self-described as having urinary incontinence, aged 55 to 90 years and living in the community completed a comprehensive history and physical examination. Initial presentation of urine loss was most commonly stress incontinence symptoms (35%). Scoring of peak response to volume lost and frequency revealed urine loss necessitating a clothing change for 78% and daily loss experienced by 73%. Over half had experienced a urine loss problem for more than five years. Most (65%) had sought treatment, but a minority reported current (11%) or previous (36%) treatment. Thirty-six percent were found to have severe atrophic vaginitis with severe urethocele (10%), cystocele (13%), rectocele (12%) less common. Pelvic floor strength by clinical scoring was weak (mean, 1.05 on a 5-point scale). The vaginal electromyograph first contraction peak mean was 5.94 microvolts sustained at 50% or better for 3.92 seconds. Clinical criteria established that 66% had stress, 27% a mixture of stress and urge, only 4% pure urge incontinence, and 4% other.
Wells
T J
TJ
University of Rochester, School of Nursing, NY 14642.
Brink
C A
CA
Diokno
A C
AC
D000368:Aged; D005260:Female; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D014549:Urinary Incontinence / Q000175:diagnosis*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis*; D014563:Urodynamics; D014882:Water-Electrolyte Balance