Urinary Incontinence Revisited: George Kuchel & Alison Huang
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
45 min
2 speakers
8 chapters
transcribed 9 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is urinary incontinence and why is it considered a geriatric syndrome?
This episode of the JerryPal Podcast is CME eligible.
To claim credit, please go to the CME tab on jerrypal.org.
Welcome to the Jerry Pal podcast. This is Eric Quadera.
This is Alex Smith.
And Alex, who do we have with us today?
Today we're delighted to welcome George Cushell, who is a geriatrician and chief of geriatrics and director of the Yukon Center on Aging at the University of Connecticut. George, welcome to the JerryPound Podcast.
Hi guys. Nice to be on.
And we're delighted to welcome Alison Huang, who's a primary care doc and researcher and professor of medicine, urology and epibiostats at UCSF in the Division of General Internal Medicine. Alison, Alison and I go way back. Welcome to Jerry Powell.
Thank you. Delighted to be here.
Little known fact. We go way, way back. Allison and I were in med school together. She invited me over to her apartment to watch Buffy the Vampire Slayer. I accepted, went there and met my future wife, Cindy Shu.
No way. Really? Yes.
Also a med student. Yep.
All thanks to Allison. Like to take credit.
That's real history in the making.
Well, before we start on our topic, which is urinary incontinence, we always ask for a song request. Who has a song request for Alex?
Well, I think we want to go with Oops, I Did Again by Brittany Spears.
Very apt for the title of Urinary Incontinence. I suggested Even Flow.
It's a good one. We'll do that on save that one for future podcasts. I do like that one. And someone else suggested under pressure, but we'd already done it. And uh of course we did let it go on our last podcast about urinary incontinence with Scott Bauer and uh Chrissy Kissler. All right, here's a little bit.
I think I did it again, I made you believe we're more than just friends. It might seem like a crush, but that doesn't mean I'm serious 'cause to lose all my senses. That is just so typically me. Ooh, baby, baby, oops, I did it again. I played with your heart, got lost in the game. Oops, you think I'm in love? I'm sent from above. I'm not that innocent.
That was great, Alex. Britney Spears has got nothing on you.
Agreed.
Well, we got we got a lot to cover on today's podcast. We're gonna be talking about urinary incontinence. And I'm gonna start off with you, George. Like, how do you think about this? Like, is this just a bladder problem? Or is this a bigger, you know, geriatric syndrome problem?
So I would say that as many many clinical issues in older adults, we need to think about them in two ways. Incontinence and voiding issues can present in an older individual's in some cases, just like they do younger person. You know, you could you certainly can have a Uh as as Alison knows well, you can have an old older lady who has stress incontinence while coughing or or or playing tennis, just like a younger woman and and the issues are essentially the same. But then there is incontinence, which is the same term, same word, but actually presents as a geriatric syndrome. And it's it's really a different different kettle of fish. The only thing they have in common is that that involves the outcome, which is incontinence, and the billing code.
But as a term implies, there are geriatric syndromes. And uh what that means is these are these are multifactorials that occur later in life most typically. Typically, and so they have multiple etiologies. There's no single risk factor. There are multiple different risk factors, both predisposing and precipitating, just like we see with delirium, just like we see with frailty and other geriatric syndromes. And the other thing they have in common is that geriatric syndromes cross typical boundaries.
How does frailty, disability, and cognitive decline relate to urinary incontinence?
You know, they cross typical, as your question alluded to. It's not just a bladder problem but but issues having to do with mobility and fluid balance and and cognition are are closely closely related. So yeah, so similar yet very different.
Yeah. Why is it associated with aging? Like what's the aging component? Just that these things like functional issues are common in older adults, cognition issues are common in older adults. Is there something about what's going on there that we see that age is the most common risk factor for these things?
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Chapters
8 chapters
1
What is urinary incontinence and why is it considered a geriatric syndrome?
0:00–4:14
2
How does frailty, disability, and cognitive decline relate to urinary incontinence?
4:14–10:05
3
Why is a 48‑hour voiding diary essential for assessing incontinence in older adults?
10:05–16:13
4
When should clinicians order a urinalysis for patients with urinary symptoms?
16:13–23:06
5
What non‑pharmacologic strategies (e.g., scheduled voiding, pelvic‑floor therapy, distraction) are most effective?
23:06–28:18
6
When are ‘last‑ditch’ pharmacologic treatments appropriate and how do they differ for men vs. women?
28:18–34:44
7
What do landmark studies by Neil Resnick and Joe Ouslander reveal about mixed over‑/under‑active bladder in the elderly?
34:44–40:07
8
What practical tips can clinicians use to improve screening, education, and treatment adherence for urinary incontinence?
40:07–45:04
Speakers
2 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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