Case Study-

Disorders of the Bladder and Lower Urinary Tract

Alvita is a frail 89-year-old woman residing in a nursing home. She is able to move slowly around the residence with the use of a walker, but appreciates when her daughter is there to hold her arm and walk alongside her. When one of the health care staff changes Alvita, her daughter helps. Alvita's incontinence has progressed, particularly over the last six years since she has resided in the nursing home. Alvita can smile at her lack of bladder control, however, and says that her incontinence really began when she was a young woman, just after the birth of her second daughter.

1. Alvita's mobility is limited. How does this affect continence in the elderly?
2. Shortly after the birth of her second daughter, Alvita experienced mild incontinence, particularly after laughing or coughing. What was she experiencing? What is the pathophysiology behind this type of incontinence?