Article

Provide guidelines presented as an algorithm for practical evaluation
and first line therapy of urinary incontinence in elderly. METHODS: Guidelines using formalized consensus guidelines method. These guidelines have
been validated by a group of 40 experts quoting proposals, subsequently reviewed
by an independent group of multidisciplinary experts (urologist, general
practitioner, neurologist, gynecologist, geriatrist, specialist in physical
medicine and rehabilitation). RESULTS: By means of 3 rounds of interrogation of
the expert panel, GRAPPPA algorithm was constructed. This algorithm take in
account both evaluation and first line therapeutic options in the different type
of incontinences observed in this population (urge, stress and mixed
incontinence). Initial evaluation consists to track down urinary retention (and
subsequently fecal stool impaction, use of anticholinergic or morphinic drugs),
urinary tract infection and cognitive impairment. Haematuria, bladder-pelvic
pain, history of radiotherapy or recent pelvic surgery, lead to refer the patient
to a specialized unit. First line therapy is in all the cases pelvic floor
training, use of local oestrogenotherapy and dietetic measures. In urge
incontinence, anticholinergic drugs may be used. CONCLUSIONS:
Implementation of
this algorithm may promote best practice in management of urinary incontinence in elderly.
CI - Copyright (c) 2013 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS

Tiré à part : OUI