Uro-gynecologic disorders in female geriatric patients

As geriatric patients those above 60 years of age are described. Incontinence is not necessarily an associated symptom of old age. In women above 60 years 15-30% suffer from urinary incontinence. With advancing age the prevalence rises to more than 40%. The cause of miction trouble must not be sought only in the urogenital tract, where with advancing age under the influence of atrophic processes typical functional and anatomical changes take place, but also in the sphere of the CNS where in geriatric patients may be the cause of impaired continence. A preliminary classification of urinary incontinence may be made already on the basis of a detailed case-history. Data provided by the patient are usually not sufficient and it is necessary to obtain the required information on the character of incontinence by aimed questions. Furthermore it is of interest what sort of medication the patient is taking at the time, incl. medication she take spontaneously. Sometimes after mere discontinuation of certain drug groups complaints can be markedly reduced or completely eliminated. In the case-history we must always focus attention on risk factors associated with incontinence and questions on the abuse of alcohol are also justified. Somatic examination comprises gynaecological examination for evaluation of the anatomical characteristics at rest and during elevated intraabdominal pressure. Functional geriatric examination is the starting point for optimal care of old people. There is a number of functional geriatric tests. For clinical practice due to its straightforward character Barthel's test of basic everyday activities is useful. Urodynamic examination is not essential in geriatric patients. Information obtained in diagnostic processes may serve as a basis for rational therapy of incontinence. Different urodynamic methods are used in case therapy fails or when the anamnestic data are obscure.