Incontinence in the Elderly: Objective Demonstration and Quantitative Assessment

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Abstract
Summary— Subjective and objective methods of demonstrating incontinence and assessing its severity have been compared in a group of elderly patients with a high incidence of severe urge incontinence. It was found that 24‐h in‐patient monitoring of urine leakage was the most sensitive method of demonstrating incontinence, with videourodynamic testing almost as good. In comparison, a 1 ‐h pad test was poor. Visual inspection during physical examination seldom demonstrated leakage. For quantitative assessment of severity, 24‐h monitoring gave the most reproducible results; it was also able to reveal significant changes in severity in response to pharmaceutical treatment. A 1 ‐h pad test was less reproducible and suggested changes that were only poorly consistent with 24‐h monitoring. The subjective responses of the patients were not useful in assessing changes in the severity of incontinence. Twenty‐four hour monitoring thus stands out as a superior method of demonstrating and assessing incontinence.