Nadège Chéry, PhD
Geriatrics & Aging
The human body undergoes important physiological changes as it ages1,2 and the urinary system is no exception to this trend.3 A major consequence of this decline in urinary function is urinary incontinence, which is defined as the inability to control urination.4 Urinary incontinence affects approximately 50% of all nursing home residents and frail, homebound, elderly individuals.3 It may be temporary or permanent, and can result from one of a variety of dysfunctions that occur in the urinary tract.4 Urinary incontinence may cause impaired healing of perineal pressure sores and rashes, and may eventually lead to psychosocial effects, including embarrassment, social isolation and depression of the affected elder.3
The pathophysiology & clinical presentation of urinary incontinence
Urinary incontinence results from defects in neurologic or anatomic aspects, and it is these defects that interfere with normal urinary micturition.4 Alteration of the normal contraction and emptying of the bladder is one important cause of urinary incontinence. Normally, both the somatic and the autonomic nervous system innervate the bladder. The relaxation and filling of the bladder are both under sympathetic control, which produces an increase in the b-adrenergic tone of the bladder.