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Urinary incontinence
Case study Kate is a 62-year-old kindergarten teacher. At least weekly she has a strong sense of urgency to urinate that is followed by urinary leakage when she rushes to the bathroom during her lunch break. She also infrequently leaks drops of urine while exercising. Kate’s body mass index is 31 and she has mild hypertension, for which she is treated with amlodipine. She is planning to see her general practitioner about her symptoms next week. How should she be managed? Introduction Urinary incontinence is one of the most common chronic medical conditions seen in primary care, but it receives less attention than diabetes, Alzheimer’s disease and many other conditions that are less prevalent. Urinary incontinence is defined by the International Continence Society as the complaint of any involuntary leakage of urine.1 An estimated four million Australians are affected by urinary incontinence to some degree.2 The published prevalence of urinary incontinence in Australian adults living in the community ranges from 2.2% to 13.0% in men and from 19.3% to 37.0% in women (depending on the definitions used and measures of severity) with a higher prevalence in people aged over 65 years.2,3 Incontinence is under-reported, and people often delay seeking help. This is often due to embarrassment or the belief that incontinence is a normal part of the ageing process, and a lack of awareness that effective treatment is available.4 The prevalence is much higher in those living in residential care and institutions; between 32% and 78% of adults living in long-term care facilities are estimated to experience urinary incontinence.2 Incontinence is considered a significant predictor for institutionalisation of the elderly. Urinary incontinence has both physical and psychological consequences, including damage to skin, urinary tract infections, an increased risk of falls, avoidance of going far from home and feelings of alienation and embarrassment.5,6 Incontinence significantly impacts on quality of life and has major economic ramifications; for example, the annual costs were estimated at $1.5 billion in 2003 and are expected to increase by 200% by 2030.2 This article will discuss how pharmacists can assist in the management of incontinence, and evaluate the evidence for a range of treatment options.
History
Publication title
Australian PharmacistVolume
30Issue
4Pagination
318-322ISSN
0728-4632Department/School
School of Pharmacy and PharmacologyPublisher
Pharmaceutical Society of AustraliaPlace of publication
Deakin ACT, AustraliaRights statement
australian.pharmacist@psa.org.au Australian Pharmacist 2010Repository Status
- Restricted