Evidence report/technology assessment
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Evid Rep Technol Assess (Full Rep) · Dec 2007
ReviewPrevention of urinary and fecal incontinence in adults.
To assess the prevalence of and risk factors for urinary (UI) and fecal (FI) incontinence in adults in long-term care (LTC) settings and in the community, the effectiveness of diagnostic methods to identify adults at risk and patients with incontinence, and to review the effectiveness of clinical interventions to reduce the risk of incontinence. ⋯ Epidemiologic surveys are cost-effective ways to estimate the prevalence of UI in large nationally representative population groups. Routine clinical evaluation should include an assessment of the risk factors, symptoms, and signs of incontinence. Pregnant or menopausal women, women with vaginal prolapse, males treated for prostate disease, patients with rectal prolapse, and frail elderly and nursing home residents are high risk groups. Individualized management programs can improve continence in LTC facilities but are hard to sustain. Regular monitoring and documentation of the continence status in relation to implemented continence services should be quality of care indicators for nursing homes. Pelvic floor muscle trainings with biofeedback can resolve incontinence and improve quality of life. Surgery is effective in curing stress UI in females. Clinical interventions for UI in males and for FI in adults need future investigation. A list of research recommendations is offered.