Continence and micturition involve a balance between urethral closure and detrusor muscle activity. Urethral pressure normally exceeds bladder pressure, resulting in urine remaining in the bladder. The proximal urethra and bladder are both within the pelvis. Intra-abdominal pressure increases (from coughing and sneezing) are transmitted to both urethra and bladder equally, leaving the pressure differential unchanged, resulting in continence.
The prevalence of urinary incontinence among persons aged 80 and over is reported to be 35–40% for women and 20–30% for men. Even higher figures are reported depending on definitions used and differences in populations studied.
Treatment is keyed to the type of incontinence. The usual approaches are as follows: • Stress incontinence - Surgery, pelvic floor physiotherapy, anti-incontinence devices, and medication • Urge incontinence - Changes in diet, behavioral modification, pelvic-floor exercises, and/or medications and new forms of surgical intervention • Mixed incontinence - Anticholinergic drugs and surgery
According to the researchers, fun is a recipe for success. “Compliance with the program is a key success factor: the more you practice, the more you strengthen your pelvic floor muscles.