Factors Distinguishing Continent vs. Incontinent Older Adults with Detrusor Overactivity

Aims of Study In the traditional paradigm, urge incontinence is ascribed to detrusor overactivity (DO). However, recent data reveal that DO occurs in one-third of continent older adults, which poses a potential problem for the traditional paradigm. We reasoned that in older adults DO might still be central to urge incontinence but that differences in the characteristics of the DO or in an individual's ability to suppress or compensate for it might account for the apparent paradox. We postulated that: ability to avert leakage associated with DO during urodynamic testing is positively associated with continence; mechanisms underlying the ability to avert leakage are also associated with continence; functional bladder capacity is negatively associated with continence; warning (the difference in bladder volume between first desire to void and strong desire to void during urodynamic testing) is positively associated with continence.