The management of incontinence.

INCONTINENCE of urine and faeces provides one of the great problems in geriatric medicine. It is a problem to which physicians on the whole have given little thought. Yet urinary incontinence in particular keeps large numbers of elderly people in hospital who could otherwise leave, and involves a disproportionate amount of nursing time. It is important, therefore, that physicians should have some knowledge of aging as it affects the bladder and the bowel, and that they should develop a rational approach to the problems of incontinence. Incontinence of urine and incontinence of faeces have different causes, and must, therefore, be considered separately. Faecal incontinence is largely a preventable condition and will be dealt with briefly at the end of this paper. Urinary incontinence, on the other hand, is more frequent and more intractable. It is the main subject to be discussed. Urinary incontinence will be considered under three headings-first, the characteristics of the aging bladder both in incontinent and nonincontinent people; second, investigation of incontinence; and third, its treatment.