International Continence Society white paper on ethical considerations in older adults with urinary incontinence

Suskind, Anne M.; Vaittinen, Tiina; Gibson, William; Hajebrahimi, Sakineh; Ostaszkiewicz, Joan; Davis, Nina S.; Dickinson, Tamara; Spencer, Martha; Wagg, Adrian

doi:10.1002/nau.24795

Cited by 13 publications

(8 citation statements)

References 66 publications

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“…of multiple treatments because adding an additional workload may lead to diminished self-care, lower adherence to treatments, and worse treatment outcomes. 24 Therefore, to reduce the frequency of sUTI, urinary and bowel management should be appropriately dealt with through a multidisciplinary approach, and the treatment burden should be reduced as much as possible. From a functional point of view, the bladder and colon are positioned close to each other in the pelvis, and urination and defecation are neurologically closely regulated.…”

Section: Discussionmentioning

confidence: 99%

“…ISC and bowel management are time‐consuming and require a longer duration of management, resulting in a relatively high therapeutic burden, and are associated with a lower QOL for people with an SCI 22,23 . The potential burden of each treatment should be taken into account when considering the continuity of multiple treatments because adding an additional workload may lead to diminished self‐care, lower adherence to treatments, and worse treatment outcomes 24 . Therefore, to reduce the frequency of sUTI, urinary and bowel management should be appropriately dealt with through a multidisciplinary approach, and the treatment burden should be reduced as much as possible.…”

Section: Discussionmentioning

confidence: 99%

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Hygiene management of intermittent self‐catheterization using reusable silicone catheters in people with spinal cord lesions: A cross‐sectional Internet survey in Japan

Takahashi

Sekido

Matsuoka

et al. 2023

LUTS

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ObjectivesTo investigate hygiene management and catheter maintenance of reusable silicone catheters for intermittent self‐catheterization (ISC) in Japan and examine their relationship with symptomatic urinary tract infection (sUTI).MethodsWe conducted a cross‐sectional Internet survey of people performing ISC using reusable silicone catheters owing to spinal cord lesions in Japan. Hygiene management and catheter maintenance of reusable silicone catheters and the incidence and frequency of sUTI were evaluated. We also examined the significant risk factors for sUTI.ResultsOf 136 respondents, 62 (46%), 41 (30%), and 58 (43%) washed hands with water, washed hands with soap, and cleaned or disinfected the urethral meatus every time or most of the time before ISC, respectively. No significant difference was observed in the incidence and frequency of sUTI between respondents who adhered to these procedures and those who did not. There were no significant differences in the incidence and frequency of sUTI in respondents who changed their catheters every month and in those who changed their preservation solution within 2 days compared with those who did not. In multivariate analysis, pain during ISC, inconvenience of indoor mobility, bowel management problems, and participants' feeling of never having received instruction on catheter replacement were significant risk factors for sUTI.ConclusionsThere are individual differences in hygiene management and catheter maintenance of reusable silicone catheters, but the influence of these differences on the incidence and frequency of sUTI is not clear. Pain during ISC, bowel management problems, and inadequate instruction on catheter maintenance procedures are factors associated with sUTI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hygiene management of intermittent self‐catheterization using reusable silicone catheters in people with spinal cord lesions: A cross‐sectional Internet survey in Japan

Takahashi

Sekido

Matsuoka

et al. 2023

LUTS

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“…Although established as 1st line treatment for all women with UI, PFM training is still not routinely available to many incontinent women worldwide [ 24 ]. More specifically, those with presumed determinants of treatment failure (mixed UI, older age, or severe UI symptoms) are often directly directed to either drug treatment (mixed UI) [ 25 ] or surgery (older age or severe UI) [ 26 , 27 ] despite the known adverse effects [ 28 ]. Knowing that PFM training effects on LH shape were sustained and consistent across potential effect modifiers only reinforces the recommendation that PFM training should be made more available and offered routinely for all women with UI.…”

Section: Discussionmentioning

confidence: 99%

Never Too Late to Train: The Effects of Pelvic Floor Muscle Training on the Shape of the Levator Hiatus in Incontinent Older Women

Cacciari

Morin

Mayrand

et al. 2022

IJERPH

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Pelvic floor muscle (PFM) training is the first-line treatment for women of all ages with urinary incontinence (UI), but evidence supporting its effects on the functional anatomy of the pelvic floor is scarce in older women. We aimed to evaluate the long-term (one-year) effects of PFM training on the shape of the levator hiatus (LH) in older women with UI and its association with PFM force, incontinence severity, and potential effect modifiers (age, UI severity, BMI, and UI type). This is a secondary analysis of the GROUP study, a non-inferiority RCT assessing the effects of a structured and progressive 12-week PFM training program to treat UI in older women. Data were available from 264/308 participants at the one-year follow-up. PFM training resulted in reduced LH size toward a more “circular” shape, which was consistently associated with greater PFM force and reduced UI severity. Further, no significant interactions were found between LH shape changes and any of the potential effect modifiers, suggesting that women will potentially benefit from PFM training, regardless of age, UI severity, BMI, and UI type (stress or mixed), with changes that can be observed in the functional anatomy of the pelvic floor and sustained in the long-term.

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“…Urinary incontinence (UI) is a common health issue that affects 30%-40% of community-dwelling older people globally (Suskind et al, 2022). However, UI is largely underreported and poorly managed among older people in primary care settings (Yan et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…The number of older people aged 65 or over will double from 703 million in 2019 to over 1.5 billion by 2050 (UN, 2019). Globally, UI affects up to 40% in the population aged over 60 years (Suskind et al, 2022). In this study, we adopted the definition of UI described by the International Continence Society (ICS) as an ‘involuntary loss of urine that is a social or hygienic problem’ (Abram et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of primary health care nurses and general practitioners in the care of older people with urinary incontinence

Yan,

Xiao,

Tang

et al. 2023

Journal of Advanced Nursing

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AimsTo identify the challenges and opportunities among primary health care nurses and general practitioners (GPs) in the care of older people with urinary incontinence (UI) and other chronic conditions in China.BackgroundUI is highly prevalent among community‐dwelling older people with chronic conditions but is underreported and poorly managed. Understanding the factors that affect primary health care professionals' practices in their care for this population is imperative to foster nurse‐led UI care services.DesignA qualitative descriptive study.MethodsFour focus groups were held with 24 primary health care nurses and GPs in Changsha, Hunan Province, China, between July and September 2021. A reflective thematic analysis was used to identify themes.ResultsThis study revealed misconceptions regarding older people living with UI and other chronic conditions in primary care health professional participants. Moreover, primary health care nurses had very limited autonomy in UI diagnosis and initiating care interventions for this patient population. By reflecting on practices, participants recognized various practical solutions to improve the detection and management of UI. Participants also identified barriers to accessing care services in older people with UI. They suggested changes in the health care system to achieve universal access to UI care services for older people.ConclusionNurse‐led UI care services in primary health care for community‐dwelling older people with chronic conditions are in high demand but are underdeveloped due to professional and health care system factors.ImpactFindings from this study provide new insights into challenges faced by primary health care professionals and illuminate practical solutions to address these challenges.Reporting MethodsAdherence to COREQ guidelines was maintained.Patient or Public ContributionNo patient or public contribution.

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International Continence Society white paper on ethical considerations in older adults with urinary incontinence

Cited by 13 publications

References 66 publications

Hygiene management of intermittent self‐catheterization using reusable silicone catheters in people with spinal cord lesions: A cross‐sectional Internet survey in Japan

Hygiene management of intermittent self‐catheterization using reusable silicone catheters in people with spinal cord lesions: A cross‐sectional Internet survey in Japan

Never Too Late to Train: The Effects of Pelvic Floor Muscle Training on the Shape of the Levator Hiatus in Incontinent Older Women

Perceptions of primary health care nurses and general practitioners in the care of older people with urinary incontinence

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