Overactive bladder syndrome in the older woman: conservative treatment

Abstract

Over active bladder syndrome (OAB) is the most common cause of urinary incontinence in the older population (Gadgil and Wagg, 2008). Many women do not seek medical help and advice as they consider it to be an inevitable part of ageing. It can have significant impact on sufferers' lives and can contribute to an increased risk of falls, reduced quality of life, social isolation and depression. It is also known to be hugely underreported as patients are often too embarrassed to discuss their symptoms with members of their family or health professionals. OAB syndrome can however, be treated effectively in primary care with conservative, nurse-led treatments. This article will discuss the causes, implications, assessment and conservative treatments available to women over 65 years old presenting with OAB syndrome in primary care.

Communicating under medical patriarchy: gendered doctor-patient communication between female patients with overactive bladder and male urologists in Hong Kong

“…The unpleasant communication experiences of the participants, however, were mostly caused by the social structure of gender, power, and social hierarchy differentials with their urologists, which could be difficult to alter. To improve the communication experiences of these patients, complementary support from nurse-led clinics and patient self-help groups can assist in filling the communication gap by providing a more humanised chronic care environment for these patients [ 42 ]. Moreover, because of the sensitivity and potential embarrassment resulting from the symptoms and examination procedures that patients with OAB are subjected to, urologists in Hong Kong are advised to be more aware of communication problems that might be caused by gender-specific issues when communicating with and performing examinations on patients of the opposite sex.…”

Atuação do enfermeiro no manejo da incontinência urinária no idoso: uma revisão integrativa

“…On the other hand, some authors agree that it should be done, as many elderly pa ents restrict their fl uid intake to reduce urine produc on and, consequently, urinary incon nence (12,16) . Its reduc on, however, makes the pa ent's urine more concentrated, which can contribute to urinary tract infec on (UTI) and intes nal cons pa on, important risk factors for urinary inconnence in the elderly (18,22) .…”

“…2010 (18) Update Overactive bladder -Behavioral therapy -Urinary training -Pelvic fl oor muscle strengthening -Electro-stimulation -Topical estrogen -Reduced caffeine intake reduces bladder irritability and UI.…”

“…For elderly pa ents who experience diffi cul es to iden fy the pelvic fl oor muscles to contract, electro-s mula on can be used, as well as biofeedback or the use of vaginal cones (26) . Electro-s mula on is an adjuvant measure to strengthen the pelvic fl oor muscles and, in addi on, can be used to treat overac ve bladder, with a view to inhibi ng detrusor hyperac vity (18).…”

“…Before establishing this treatment, however, adequate assessment is needed, and elderly pa ents should be asked to complete a diary in order to check their urina on behavior (16,18) . Many elderly pa ents only experience urinary loss when their bladder is full.…”