The Continued Success Of Conservative Management For Established Urinary Incontinence In Older People

Seventy‐eight community residing patients (63% women) aged 60 years or older attending an outpatient continence clinic were randomised to receive immediate conservative (non‐surgical, non‐pharmacological) management or to a control group in which treatment was deferred for two months. All patients were followed up for 12 months. Outcome was assessed by three day bladder charts (objectively) and by patient questionnaires (subjectively). The average age was 74.8 yean and mean duration of incontinence was 7.3 years with 60% not having had any previous treatment. After four months of active treatment incontinence was cured or improved subjectively in 88% of patients and objectively in 58% of patients. This was sustained through to the 12 month follow‐up. Severity of incontinence was significantly reduced on a range of variables. Conservative management of elderly community‐based patients can be very effective, taking up to four months to see peak benefit which can be sustained over a 12 month period with little additional input. The improvement seen in the control group perhaps reflects the importance of support and destigmatisation of this condition.