Evaluation and Treatment of Urinary Incontinence
in Older Adults |
Certified
for 1 AMA PRA Category 1 Credit™
Co-Sponsored
by
the
University of Alabama
School
of Medicine
Division of Continuing Medical Education,
Division of Gerontology, Geriatrics, and
Palliative Care, and
The Center for Aging
| Release
Date: April 19, 2007 |
Expiration
Date: April 19, 2010 |
| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity,
physicians and other healthcare professionals
should be able to: |
- Discuss the causes and risk factors for urinary incontinence.
- Describe the process for evaluating urinary incontinence.
- Discuss methods of treatment and management of urinary incontinence.
|
| Top of Page |
| SOURCE: |
| EDITOR
AND CONTRIBUTING AUTHORS: |
Angela
R. Curtis, PhD
Managing Editor
Assistant Professor, Geriatric Education
Manager
Alayne Markland, DO, MSc
Assistant Professor of Medicine
Patricia S. Goode, MD, MSN
Gwen McWhorter Professor of Geriatric Medicine
Medical Director, UAB Continence Program
VA GRECC Assoc. Dir. for Clinical Programs
Division
of Gerontology, Geriatrics and
Palliative Care
University of Alabama at Birmingham
Birmingham, Alabama
|
| Top of Page |
| DISCLOSURE: |
The
faculty has no commercial affiliations
to disclose.
Because of the nature of preliminary
studies, some products mentioned are
unlabeled and investigational. Dosages,
indications, and methods of use of
drugs mentioned in this publication
may reflect the experience of the authors,
clinical literature, or other resources.
Therefore, please see the full prescribing
information before using any licensed
product mentioned. |
| CME
PARTICIPATION: |
| To
participate in this online course
for CME credit, please review the
objectives before beginning the program.
Complete the course and the self-assessment
test before April 19, 2010 to receive
CME credit. Your certificate will
then be available online. This process
should take approximately 1 hour. |
| ACCREDITATION: |
The
University of Alabama School of
Medicine is accredited by the Accreditation
Council for Continuing Medical
Education to provide continuing
medical education for physicians.
The
University of Alabama School of
Medicine designates this educational
activity for a maximum of 1 AMA
PRA Category 1 Credit™.
Physicians should only claim credit
commensurate with the extent of
their participation in the activity.
The
boards of nursing in many states,
including Alabama, recognize Category
1 continuing medical education
courses as acceptable activities
for the renewal of license to practice
nursing. |
| DISCLAIMER: |
| Dosages,
indications, and methods of use of
any drug referred to in this publication
may reflect the clinical experience
of the authors, clinical literature,
or other clinical resources. Therefore,
please see the full prescribing information
before using any product mentioned.
UAB is an equal opportunity/affirmative
action institution. |
| INTRODUCTION: |
Urinary incontinence is a common syndrome in older adults and prevalence increases with age.[1] Women are affected by urinary incontinence at higher rates than men, but gender differences may not exist after age 80. Urinary incontinence largely impacts quality of life for individuals and is a costly condition.[2,3] |
| CASE 1: |
A 75-year-old man comes to your office for an evaluation of worsening urinary incontinence over the past year. He complains of increased urinary frequency, difficulty emptying his bladder, urgency that occurs with and without urinary leakage, and 2-3 episodes of nocturia each night. He has no dysuria. He denies any history of prostate surgery or prostate cancer. He has been diabetic for the past 10 years and his last hemoglobin A1C was 9.8%. He currently takes metformin, lisinopril, and simvastatin. He has also recently started taking an over-the-counter sleep aid (diphenhydramine) for problems sleeping at night. In addition, he is drinking 4-5 diet drinks with caffeine during the day to help him stay awake. He also drinks 5-6 glasses of water. He is active in his community, but the recent worsening in his urinary symptoms is starting to affect his ability to play golf with friends. His last serum prostate-specific antigen (PSA) done 6 months ago was 1.7 and has been stable over the past two years. Digital rectal exam done at the same visit revealed a symmetric and enlarged prostate.
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