Conservative management of continence in women over the age of 65 years living in the community: a review
The purpose of this review of the literature was to evaluate the most common forms of conservative management used to manage urge, stress and mixed incontinence in women over the age of 65 living in the community. Conservative management includes non-surgical and non-pharmacological interventions such as lifestyle interventions, physical therapies, behavioural therapies and devices including pessaries. The literature shows that the most common conservative management programme is bladder retraining using pelvic floor muscle training (PFMT) with biofeedback. There is evidence that most motivated patients receive some benefit from behavioural treatment and, because it involves minimal risk or discomfort, there is no reason to discourage any older woman with stress, urge or mixed incontinence, who is motivated, to participate in behavioural management. Women, particularly older women experiencing urinary incontinence, should not be excluded from a trial of behavioural therapy in conjunction with physical therapy as well as other conservative measures. The literature illustrates a need to improve access and outcomes for the older woman to address symptoms of urinary incontinence.