Urinary incontinence is a common and often embarrassing problem for older
adults. There are many ways to treat urinary incontinence and urine leakage
problems, including bladder training, exercises, medication, and surgery.
Due to the sensitive nature of this medical issue, your patients may need your
encouragement when discussing treatment options for the management of urinary
incontinence.
The following treatment options are recommended for improving bladder control
in older adults:
1
First-line: Non-drug measures are the first-line recommended treatments for
mild symptoms (e.g., timed voids, bladder training, fluid management).
Second-line: If treatment goals are not met, oral anti-muscarinics are
recommended unless contraindicated (e.g., narrow-angle glaucoma, impaired
gastric emptying, or a history of urinary retention). Dose modification or
trial of a different anti-muscarinic medication may be warranted if a patient
experiences inadequate symptom control and/or unacceptable adverse drug events.
Third-line: Surgery is a third-line recommended treatment option for carefully
selected patients who have severe refractory symptoms.
By encouraging your patients to discuss their options, they can receive the
treatment they may need but have been reluctant to seek.
Note: Most anti-muscarinics are available on IBC's drug formulary at the lowest
level of cost-sharing.
1American Urological Association guidelines