What treatment options are available for an older adult experiencing incontinence-related embarrassment?

From the Guidelines

Older adults experiencing incontinence-related embarrassment should prioritize nonpharmacologic therapies, such as pelvic floor muscle training, bladder training, and weight loss, as first-line treatment options, as they have been shown to be effective with a low risk of adverse effects 1. These approaches can be practiced multiple times daily and have been associated with a large magnitude of benefit for increasing continence rates. Some key benefits of nonpharmacologic therapies include:

• Low risk of adverse effects
• Effective in achieving continence and improving urinary incontinence (UI)
• Can be combined with other therapies, such as biofeedback and weight loss, for enhanced benefits In addition to nonpharmacologic therapies, medications like solifenacin, darifenacin, and tolterodine can be considered for managing urgency UI, as they have been shown to be effective with a moderate magnitude of benefit, although they may be associated with adverse effects 1. It is essential to weigh the benefits and harms of pharmacologic therapies and consider the individual patient's needs and preferences. Some key considerations for pharmacologic therapies include:
• Solifenacin has been associated with the lowest risk for discontinuation due to adverse effects
• Tolterodine and oxybutynin have been shown to be equally efficacious, although tolterodine may cause fewer harms
• Identifying and managing underlying conditions that may contribute to UI, such as urinary tract infections and metabolic disorders, is crucial for effective treatment 1.

From the FDA Drug Label

Tolterodine tartrate tablets are a prescription medicine for adults used to treat the following symptoms due to a condition called overactive bladder: •• Urge urinary incontinence: a strong need to urinate with leaking or wetting accidents •• Urgency: a strong need to urinate right away •• Frequency: urinating often

The treatment options available for an older adult experiencing incontinence-related embarrassment include tolterodine tartrate tablets. This medication is used to treat symptoms of overactive bladder, such as urge urinary incontinence, urgency, and frequency. It is essential to consult a doctor to determine if tolterodine tartrate tablets are right for the individual, as they will assess the patient's condition and medical history to decide on the best course of treatment 2 2.

Key points to consider:

• Tolterodine tartrate tablets are for adults only
• The medication should be taken exactly as prescribed by the doctor
• Patients should inform their doctor about all medical conditions and medications they are taking
• Possible side effects of tolterodine tartrate tablets include allergic reactions, blurred vision, dizziness, and drowsiness

From the Research

Treatment Options for Older Adults Experiencing Incontinence-Related Embarrassment

• Various treatment options are available for older adults experiencing incontinence-related embarrassment, including surgical procedures, medications, and behavioral techniques 3.
• Surgical procedures, such as those to rectify an incompetent sphincter, have been shown to be effective and are generally accepted 3.
• Medications, such as anticholinergic drugs, can be used to control detrusor instability and are often used in combination with behavioral techniques 4, 5.
• Behavioral techniques, such as bladder training and pelvic floor exercises, can be effective in managing overactive bladder symptoms and can be used in combination with medication 4, 6.

Non-Invasive Interventions

• Bladder training, which involves gradually increasing the time between trips to the bathroom, can be an effective non-invasive intervention for managing overactive bladder symptoms 6.
• Pelvic floor exercises, also known as Kegel exercises, can help strengthen the muscles that control urination and can be used in combination with bladder training 4.
• Lifestyle modifications, such as avoiding caffeine and alcohol, can also help manage overactive bladder symptoms 4.

Pharmacological Interventions

• Anticholinergic drugs, such as oxybutynin and tolterodine, can be used to control detrusor instability and are often used in combination with behavioral techniques 4, 5.
• The choice of medication depends on the individual's specific needs and medical history, as well as the potential side effects of the medication 4, 5.
• Newer medications, such as solifenacin succinate and darifenacin, have been developed to have fewer side effects and may be more effective for some individuals 4.

Importance of Seeking Medical Attention

• Older adults experiencing incontinence-related embarrassment should seek medical attention to discuss their treatment options and develop a plan to manage their symptoms 3.
• Healthcare providers should be alert to the possibility of incontinence among their clients and should ask older patients directly about their symptoms, as many patients may be too embarrassed to mention them 3.