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Europa Medicophysica 2003 June;39(2):101-10
Copyright © 2003 EDIZIONI MINERVA MEDICA
language: English
Criteria for prescribing aids for the management of urinary incontinence
Benvenuti F. 1, Banfi R. 2, d’Ippolito P. 3, Cottenden A. 4, Mencarelli M. A. 1, Di Benedetto P. 5
1 Department of Geriatrics, INRCA “I Fraticini”, Florence, Italy 2 Pharmaceutical Service, Azienda Sanitaria di Firenze, Florence, Italy 3 Institute of Gerontology and Geriatrics University of Florence, Florence, Italy 4 Departments of Medical Physics and Bioengineering/Medicine Continence Technology Group University College London, London, England 5 hysical Medicine and Rehabilitation Institute Medicine Department, Udine, Italy
The term “social continence” is used to describe the condition in which urine losses are contained, to ensure the dignity and hygiene of the patient and the living environment, by using aids applied to the individual. The devices used may be external (absorbent products, external catheters) or internal (Foley type catheters). An ideal anti-incontinence aid must be capable of separating the patient from his or her excrements without collateral effects. However, no device exists that can offer these characteristics. All the products used have both advantages and disadvantages. The devices that ensure social continence disguise but do not cure the problem. Consequently, their inappropriate use tends to turn conditions that would otherwise be reversible if treated, into chronic forms. This has heavy consequences both in terms of quality of life for the patients and of economic costs (for the National Health Service and families). We emphasize the importance of a targeted clinical assessment in patients wearing incontinence aids without having previously undergone an adequate evaluation. The clinical assessment is also essential for choosing the type and the characteristics of the appropriate aid. This depends on a number of factors which must be carefully evaluated: post-void residual volume, frequency, severity and daily rhythm of urine loss, co-existence of fecal incontinence, capacity to use the toilet and/or its substitutes and/or the aid independently (this depends extensively on the cognitive state, locomotion and manual dexterity), lifestyle, motivation and collaboration, social support, associated pathologies and prognosis, cost and possibility of prescription from The National Health Service. The aim of this article was to outline the criteria for prescription on the basis of the evidence presented.