Urinary and fecal incontinence in the elderly from the gynecoproctological viewpoint

Three to four million women suffer from urinary incontinence (Ul) in Germany. This number will rise further as life expectancy increases, and there is an annual incidence of newly occurring Ul of about 1%. Two thirds of all women with UI suffer additional symptoms of fecal incontinence. The type of incontinence present is diagnosed on the basis of the patient's history, clinical findings, and functional testing. The findings should be interpreted in an age-adjusted manner to avoid overrating (e.g. urethral closure pressure at rest=100-age in cm H2O). The management of elderly patients focuses on conservative approaches with bladder and intestinal training as well as dietary measures serving to counteract the age-related loss of intellectual abilities. Local estrogen application has a positive effect on all forms of incontinence. Surgical approaches aim at improving symptoms since forced restoration of continence in elderly patients frequently induces voiding disorders.