This study has two purposes: (1) to discover the characteristics of urinary incontinence in a minimum of 200 women 55 years and older, living in the community and having this complaint, and (2) to test interventions whose modalities are appropriate for nursing management to reduce to resolve urinary incontinence. These two purposes are interrelated because interventions are most likely to be successful if specific to etiology and there are multiple causes of loss of urine control. Thus, phase one of the study is a comprehensive evaluation of urinary incontinence in these subjects, including history gathering, physical examination, and urodynamic tests. Characteristics of the study population will be summarized, relationships between important measures identified and analyzed via regression analysis or cross tabulation. Phase two will continue for those subjects identified by urodynamic measures to have either bladder instability (the bladder contracts unihibitedly causing symptoms of stress and urge incontinence) or stress incontinence (leakage of urine without bladder contraction due to a rise in intra-abdominal pressure). Subjects with bladder instability will be assigned either a 3 month bladder training exercise program consisting of daily practice consciously overriding bladder fullness signals to increasingly delay voiding and increase functional capacity or a six week drug program of either propantheline or oxybutynin chloride. Subjects with stress incontinence will be assigned either to a six month pelvic floor exercise program consisting of daily practice actively contracting those muscles or a six week drug program of phenylporpanolamine. Successful subjects will be followed at three month intervals, failures will cross over to receive the additive treatment within their diagnostic category. Success rates for the exercise and drug treatment groups will be compared and the relationship between success rate and other factors analyzed by logistic regression.
| Wells, T J; Brink, C A; Diokno, A C et al. (1991) Pelvic muscle exercise for stress urinary incontinence in elderly women. J Am Geriatr Soc 39:785-91 |
| Brink, C A; Sampselle, C M; Wells, T J et al. (1989) A digital test for pelvic muscle strength in older women with urinary incontinence. Nurs Res 38:196-9 |
| Shimp, L A; Wells, T J; Brink, C A et al. (1988) Relationship between drug use and urinary incontinence in elderly women. Drug Intell Clin Pharm 22:786-7 |
| Brink, C A; Wells, T J; Diokno, A C (1987) Urinary incontinence in women. Public Health Nurs 4:114-9 |
| Wells, T J; Brink, C A; Diokno, A C (1987) Urinary incontinence in elderly women: clinical findings. J Am Geriatr Soc 35:933-9 |
| Diokno, A C; Wells, T J; Brink, C A (1987) Urinary incontinence in elderly women: urodynamic evaluation. J Am Geriatr Soc 35:940-6 |
| Diokno, A C; Wells, T J; Brink, C A (1987) Comparison of self-reported voided volume with cystometric bladder capacity. J Urol 137:698-700 |
