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Page Background


Urinary tract infections (UTI) in elderly are frequent and

polymorphic clinical symptoms. This is a public health problem both

in support and cost they generate. The aim of the study is to study the

epidemiological, clinical, paraclinical and therapeutic aspects of UTI

in the elderly.


We conducted a retrospective study of 50 cases of UTI in the

elderly collected in the Internal Medicine Department at Habib

Thameur Hospital between January 2011 and December 2015 (Group

I). We compared this group to another group of patients aged below 60

years also explored for UTI in the same service and during the same

period (Group II).


They were 37 women and 13 men in group I and 41 women

and 9 men in the group II. In group I, the average age was 74.10 ± 6.7

years, in group II 43.58 ± 11.26 years. In group I, 35 patients (70%)

showed no evidence of suspicion of a UTI on admission. 15 patients

(30%) were admitted for suspected UTI. In group II, 36 patients (72%)

showed no evidence of suspicion of a UTI on admission. 14 patients

(28%) were admitted for suspected UTI.

Urological abnormalities underlying the UTI, detected by ultrasound,

were more frequent in Group I (40%) than in Group II (12%).

Second-line antibiotics, due to the likely resistance of the micro-

organism, had to be prescribed in 16% cases in Group I vs. 4% of cases

in Group II. The evolution under antibiotic treatment was marked by

the occurrence of 3 deaths and transition to renal failure in 4 cases for

Group I. In Group II, the outcome was favorable in all cases.


Penile Cuff Test in old patients: feasibility in real life

D. Carnicelli, G. Fiard, C. Thuillier, G. Gavazzi.

Urology and Renal

Transplant Units and University Clinic of Geriatric Medicine, University

Hospital of Grenoble-Alpes


The aim of this study was to assess the Penile Cuff Test

(PCT) feasibility (non invasive cystomanomety) on a daily practice, for

patients admitted for a treatment of lower Urinary tract symptoms.


During the first three months of 2014, all patients admitted

at University Hospital of Grenoble for a procedure to relieve prostate

obstruction were included in the study (>50 years). All categories

of limitations to the use of PCT were collected; for patients

who underwent PCT, figures of pressure flow were collected on the

modified nomogram of the ICS.


Fifty patients were included (mean age 76 y (50

92). Out of

50, 16.4% of the patients could perform PCT. 60% were showing an

obstruction (average voided volume 181,8 mL). Limitations to PCT

realizationwere, presence of urethral, or a suprapubic catheter (30,9%),

severe cognitive disorder (12.4%), no urge to urinate (16.4%), technical

problem during the procedure (16,4%), patients had urethral stenosis

(5,4%). The mean prostate volume was 60 g (30

120). The mean IPSS

score was 18.8/35 (7

31), and the average index of quality of life was

4.78/6 (2

6). Procedure duration was 10 minutes. Eligible patients

rated the difficulty to use the PCT 3/10 on an EVA scale (0 = very easy,

10: very difficult).

Key conclusions:

This study highlighted the requirement to select

patients precisely, despite that elderly patients should get the greatest

benefit from PCT. Severe cognitive trouble, frequent preoperative

urinary retentions are the main limitations. patients who underwent

PCT found it simple.


What patients don

t tell and what we do not ask? Continence

service development steering group at district general hospital

A. Jakupaj, C. Martin-Marero.

Luton and Dunstable Hospital NHS Trust

Urinary and faecal incontinence becomes increasingly prevalent with

age. Despite the frequency of the problem, bladder and bowel dysfunc-

tion is not talked about openly. In our Trust in survey questionnaire,

90% of patients complaint of urinary incontinence, 65% complaint

of faecal incontinence. Promoting awareness of continence issues

and development of structured continence pathway may reduce

prevalence of urinary and faecal incontinence in our Trust and

improve patient

s quality of life. We introduced Continence Steering

Group and Continence Service to identify and improve the gaps in

continence care. Our project was divided into 3parts: 1. Catheter

Audit 35/103 patients had an indwelling catheter, 24/35 short term

catheter, only 3/24 had TWOC, 2/24 had procedure explained to

them and 2/24 had documented consent, 8/24 had bowel assessment

done prior catheterisation and 1/11 patients had prostate examined.

2. Urinary Continence Audit 64/103 patients with urinary incon-

tinence(UI). 60% of patients had UTI/Urosepsis with the subsequent

morbidity with potential increased mortality. There was also poor

awareness of the importance of concomitant bowel management

and prostate assessment in the care ofUI. 3. Faecal Continence Audit

33/103 patients with faecal incontinence (FI). 40% of FI was asso-

ciated with dementia,faecal loading and poor mobility. 58% of patient

were FI daily. We identified very poor history and examination to look

for cause of FI including basic rectal and abdominal examination.

Urinary and faecal continence is common yet not comprehensively

assessed. Partial assessments are leading to partial management of

the causes of UI and FI with poor implementation of the right

treatments. We have identified important educational and clinical

governance issues to be addressed in different forums. We developed

Continence Steering Group to improve our service and introduce

continence pathways. A prospective study is currently being under-

taken to validate this.


Kegel exercises in the incontinent older woman

is it worth it?

J. Mata


, M. Galo


, S. Pessoa


, I. Calvinho




UCSP Marvila,


USF Oriente,



Urinary incontinence is a common affliction in women,

especially in the elderly. While some cases might need surgery

to mitigate the symptoms, others will not be eligible for it. Kegel

exercises have shown a beneficial impact in urinary incontinence

progression in younger age groups, so the transposition of these results

to the elderly women would allow an improvement in quality of life

without aggravating the polymedication concern.


To evaluate the efficacy of Kegel exercises in urinary

incontinence symptoms in the elderly.


We searched PubMed with the terms: incontinence, Kegel

and elderly with a time frame from 01/01/2000 to 30/04/2016.

The Grading of Recommendations, Assessment, Development and

Evaluation (GRADE) system was used to rate the quality of the evi-

dence and recommendations.


Our systematic search returned 27 papers from which 2

matched the inclusion criteria of women with at least 65 years and

the evaluation of Kegel exercises efficacy. Considering a low quality

of evidence from a randomized controlled trial and a prospective

study, with a total of 87 participants, we could only provide a weak

recommendation for the application of Kegel exercises.


In both cases the routine of Kegel exercises showed

an improvement (32% and 36.4%) in the PAD test after 8 weeks of

treatment. We can say that the Kegel exercises could be recommended

to selected patients. However, it is necessary to conduct randomized

clinical trials with larger samples and longer follow-ups to determine

the real benefit in the elderly women.


Prospective study of the impact of urethral catheterization on

geriatric inpatients

J.E. Mateus


, C. Silva


, O. Oliveira


, P. Lopes


, J. Fonseca


, D. Ferreira



J. Porto


, M. Veríssimo


, A. Carvalho




Centro Hospitalar e Universitário

de Coimbra, Portugal


Catheter-Associated Urinary Tract Infection (CAUTI)

remains one of the most common healthcare-associated infections.

International guidelines agree on appropriate indications for the use of

urethral catheterization (UC): acute urinary retention, perioperative

Poster presentations / European Geriatric Medicine 7S1 (2016) S29