Help for People with Urinary Incontinence
Press Release Date: March 5, 1996
Today there is more help available for millions of Americans who
suffer from urinary incontinence
(UI), or the involuntary loss of urine. The Agency for Health
Care Policy and Research
(AHCPR) today released an updated version of its clinical
practice guideline first issued in March
of 1992, which shows that 80 percent of cases can be improved or
cured by following the
recommendations. The new report has expanded sections on
diagnosis and behavioral therapies,
as well as a new chapter on treating chronic UI in long-term and
home care settings.
AHCPR also announced a partnership with the American Medical
Directors Association (AMDA)
and the American Health Care Association (AHCA) to develop new
educational materials to be
used by caregivers to reduce the incidence of UI. Urinary
incontinence is one of the primary
contributing reasons that people enter nursing facilities. Use
of the guideline may help people stay
at home longer and improve the quality of life for persons at
home or in facilities. The first of
these new educational products will be available this spring.
"This updated guideline, which replaces the first version,
reaffirms the work of the 1992 panel
which showed that urinary incontinence is treatable and that
people don't have to suffer in
silence," AHCPR Administrator Clifton R. Gaus, Sc.D., said. "The
new guideline continues to
emphasize that patients must feel free to discuss the problem
with their doctor or nurse, and all
clinicians must take the problem seriously, so they can get the
help that is available and regain
control of their lives."
Researchers estimate the nation spends at least $16 billion a
year to care for people with urinary
incontinence, up from $10 billion in 1990. Urinary incontinence
is estimated to affect more than
13 million adults—most of them older women—but actual
prevalence may be higher
because it is widely underreported and underdiagnosed.
"We made a good start with the first guideline by bringing this
problem out into the open and
telling people there is help for incontinence," said Andrew J.
Fantl, M.D., professor and vice-chair
of the Obstetrics, Gynecology, and Reproductive Medicine
Department at SUNY at Stonybrook
School of Medicine, and co-chair of the guideline update panel.
"Now we have the opportunity
to strengthen the message and provide clinicians with a more
user-friendly tool to really make a
difference in the quality of their patients' lives."
As with the first version, this updated guideline, developed by a
private sector, multidisciplinary
panel of clinicians and a consumer, emphasizes aggressive
diagnosis to determine the underlying
cause of the problem. Incontinence can be caused by pelvic
muscle instability, as a side effect of
medications or caffeine, or other conditions such as a urinary
tract infection or constipation. It
also can be caused by not being able to reach the bathroom in
time due to a lack of mobility.
Many younger women experience incontinence after childbirth, but
don't report it because they
feel it is an inevitable result of the birthing process, or are
embarrassed. Older men with prostate
problems or recovering from prostate surgery often suffer from
incontinence, but they are more
likely to ask for and receive help for the condition.
"Surveys have shown that women tend to accept incontinence as
their personal burden, while men
understand that this is not normal and should be treated," said
Diane Kaschak Newman, R.N.C.,
M.S.N., F.A.A.N., president of Access to Continence Care &
Treatment in Philadelphia, and
co-chair of the guideline update panel. "As clinicians we need
to make a stronger effort to ask
women about incontinence and treat it aggressively."
The guideline is written for the primary care provider and covers
various types of incontinence,
provides a framework for selecting appropriate behavioral,
pharmacologic, and surgical
treatments, and evaluates the use of alternative treatments such
as catheters and bladder support
devices. The caregiver guide being developed by AHCPR, AMDA, and
AHCA will be written
specifically for certified nursing assistants in nursing
facilities and home health aides. A
companion piece will be written for directors of nursing to help
them train caregivers.
"The guideline will make an important contribution to improving
the quality of life for so many
people suffering needlessly from urinary incontinence," said
Lorraine Tarnove, executive director
of the American Medical Directors Association. "We are committed
to helping create and
disseminate other products from this guideline which can do even
more for the residents in
nursing facilities."
A quick reference guide for clinicians, Managing Acute and
Chronic Urinary Incontinence, and
consumer guide (available in English or Spanish), Understanding
Incontinence, are available free
of charge from the AHCPR Publications Clearinghouse. Call
toll-free 800-358-9295, or write to
Urinary Incontinence Update, AHCPR Publications Clearinghouse,
P.O. Box 8547, Silver Spring,
MD 20907.
The full guideline, Urinary Incontinence in Adults: Acute and
Chronic Management, as well as the
quick reference and consumer pieces, will be available on
Internet through the AHCPR Home
Page. Access the guideline by using a Web browser, specifying
URL http://www.ahrq.gov/clinic/ and
clicking on "Clinical
Practice Guidelines Online." Single and bulk copies may be
purchased from the U.S. Government
Printing Office by calling (202) 512-1800.
The American Medical Directors Association is a national
professional organization representing
physicians who practice in long-term care facilities as medical
directors or attending physicians.
An AHCPR spokesperson will be speaking about dissemination of the
UI guideline at the AMDA
annual conference, March 7-10, in New Orleans. For further
information, call Joanne Kaldy at
(703) 841-4987.
The American Health Care Association is a federation of 51 state
associations representing more
than 11,000 long-term care facilities nationwide, caring for more
than a million elderly, chronically
ill, and convalescent Americans.
For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855 ; or Salina Prasad, (301) 427-1864.
Internet Citation:
Help for People with Urinary Incontinence. Press Release, March 5, 1996. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.gov/news/press/uiupdate.htm
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