Trastornos de la eliminación urinaria en el paciente mayor

  1. Miguel, B. Carballido de
  2. Bravo, C. Verdejo
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2018

Serie: 12

Número: 62

Páginas: 3650-3658

Tipo: Artículo

DOI: HTTPS://DOI.ORG/10.1016/J.MED.2018.09.003 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Resumen Los trastornos de la eliminación urinaria, representados fundamentalmente por la aparición de síntomas del tracto urinario inferior (STUI), constituyen uno de los problemas médico-quirúrgicos más relevantes en el paciente mayor, con un impacto negativo en su calidad de vida y considerables repercusiones en sus diferentes esferas. Sin embargo, muchos pacientes siguen sin ser diagnosticados por no consultar su problema médico, asumiendo que se trata de una patología trivial, asociada inherentemente al envejecimiento y sin tratamiento eficaz. Por las circunstancias mencionadas, en el contexto clínico y sociosanitario de los pacientes mayores, resulta imprescindible referirse a su singularidad, al tratarse de un grupo etario que con frecuencia presenta cuadros clínicos larvados, presentaciones atípicas de las enfermedades, polimedicación y una importante carga de comorbilidad. Solo de esta manera se podrá establecer adecuadamente el límite entre su dimensión clínico-patológica y la condición de envejecimiento biológico. Urinary elimination disorders, essentially represented by the onset of lower urinary tract symptoms (LUTS), comprise one of the most relevant medical/surgical problems in the elderly patient, and have a negative effect on quality of life and considerable impact on different areas. However, many patients are not diagnosed because they do not seek medical advice for their problem, considering it a trivial disorder, inherently associated with ageing and for which there is no effective treatment. Due to the above, the singularity of the elderly patient must be referred to within their clinical, social and health context, since this is an age group that often presents with latent clinical symptoms, atypical disease presentations, polymedication and a significant comorbidity load. Only thus will it be possible to appropriately establish the limit between their clinical-pathological characteristics and the condition of biological ageing.

Referencias bibliográficas

  • Clemens JQ. Basic bladder neurophysiology. Urol Clin N Am. 2010; 37: 487-94.
  • Thirugnanasothy S. Managing urinary incontinence in older people. BMJ. 2010;341:c3835.
  • Verdejo-Bravo C. Geriatric urinary incontinence: special concerns on the frail elderly. Urinary incontinence. Rijeka (Croatia): Intech; 2012. p. 113-30.
  • Jung HB, Kim HJ, Cho ST. A current perspective on geriatric lower urinary tract dysfunction. Korean J Urol. 2015;56:266-75.
  • Verdejo Bravo C. Trastornos de la eliminación urinaria en el anciano. Tratado de Medicina Geriátrica. 1ª ed. Barcelona: Elsevier; 2015. p. 429-34.
  • Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmstem U. The standardization of terminology of lower urinary tract function: report from the Standardization Subcommittee of the International Continence Society. Neurourol Urodyn. 2002;21:167-78.
  • Salinas Casado J, Díaz Rodríguez A, Brenes Bermúdez F, Cancelo Hidalgo MJ, Cuenllas Díaz A, Verdejo Bravo C. Prevalencia de la incontinencia urinaria en España. Urod A. 2010;23:52-66.
  • Aharony L, De Cock J, Nuotio MS, Pedone C, Rifel J, Vande Walle N. Consensus document on the detection and diagnosis of urinary incontinence in older people. Eur Ger Med. 2017(8):202-9.
  • Vázquez Alba D, Bustamante Alarma S, Rodríguez Reina G, Carballido Rodríguez J. Incontinencia urinaria. Medicine. 2011;10(83):5612-8.
  • Verdejo C; Méndez S; Salinas J. La disfunción del tracto urinario inferior en el paciente mayor. Med Clin. 2016;147:455-60.
  • Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C. Fourth International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse, and Fecal Incontinence. Neurourol Urodyn. 2010;29:213-40.
  • Wagg A, Gibson W, Ostaszkiewicz J, Johnson T, Markland A, Palmer MA. Urinary incontinence in frail elderly persons: report from the 5th International Consultation on Incontinence. Neurourol Urodynam. 2015;34:398-406.
  • Verdejo-Bravo C, Brenes-Bermúdez F, Valverde-Moyar V, Alcántara-Montero A, Pérez-Leon N. Documento consenso vejiga hiperactiva en el paciente mayor. Rev Esp Geriatr Gerontol. 2015;50:247-56.
  • Yared JE, Gormley EA. The role of urodynamic in elderly patients. Clin Geriatr Med. 2015;31:567-79.
  • Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. Co-chrane Database Syst Rev. 2015;(12):CD003505.
  • Stenzelius K, Molander U, Odeberg J, Hammarström M, Franzen K, Midlöv P. The effect of conservative treatment of urinary inconti-nence among older and frail older people: a systematic review. Age Ageing. 2015;44:736-44.
  • Burkhard FC, Bosch JLHR, Cruz F, Lemack GE, Nambiar AK, Thiruchelvam N. EAU. Guidelines on urinary incontinence in adults. 2017.
  • Khan I, Tariq SH. Urinary incontinence: behavioral modification therapy in older adult. Clin Geriatr Med. 2004;20:499-510.
  • Price N, Dawwod R, Jackson SR. Pelvic floor exercise for urinary incontinence: a systematic literature review. Maturitas. 2010;67:309-15.
  • Aharony L, De Cock J, Nuotio MS, Pedone C, Rifel J, Vande Walle N. Consensus document on the management of urinary incontinence in older people. Eur Ger Med. 2017;(8):210.
  • Wagg A, Verdejo C, Molander U. Review of cognitive impairment with antimuscarinic agents in elderly patients with overactive bladder. Int J Clin Pract. 2010;64:1.279-86.
  • Wagg A. Antimuscarinic treatment in overactive bladder. Special Considerations in Elderly Patients. Drugs Aging. 2012;29:539-48.
  • Wagg A, Nitti VW, Kelleher C, Castro-Díaz D, Siddigui E, Berner T. Oral pharmacotherapy for overactive bladder in older patients: mirabegron as a potential alternative to antimuscarinics. Curr Med Res Opin. 2016;32:621-38.
  • Warren K, Burden H, Abrams P. Mirabegron in overactive bladder patients: efficacy review and update on drug safety. Ther Adv Drug Saf. 2016;7:204-1.
  • Sharaf A, Hashim H. Profile of mirabegron in the treatment of overactive bladder: place in therapy. Drug Des Devel Ther. 2017;11:463-7.
  • Maund E, Guski LS, Gotzsche PC. Considering benefits and harms of duloxetine for treatment of stress Urinary incontinence: a meta-analysis of clinical study reports. CMAJ. 2017;189:E194-E203.
  • Ellington DR, Erekson EA, Richter HE. Outcomes of surgery for stress urinary incontinence in the older woman. Clin Geriatr Med. 2015;31:487-505.
  • Alawamlh OAH, Goueli R, Lee RK. Lower urinary tract symptoms, benign prostatic hyperplasia and urinary retention. Med Clin North Am. 2018;102(2):301-11.
  • Kowalik U, Plante MK. Urinary retention in surgical patients. Surg Clin N Am. 2016;96:453-67.