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Review

Vascular Incontinence: Incontinence in the Elderly Due to Ischemic White Matter Changes

1
Neurology Department, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
2
Uro-Neurology, the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
3
Neurology, Chiba University, Chiba, Japan
*
Author to whom correspondence should be addressed.
Neurol. Int. 2012, 4(2), e13; https://doi.org/10.4081/ni.2012.e13
Submission received: 22 August 2011 / Revised: 17 December 2011 / Accepted: 16 January 2012 / Published: 6 September 2012

Abstract

This review article introduces the new concept of vascular incontinence, a disorder of bladder control resulting from cerebral white matter disease (WMD). The concept is based on the original observation in 1999 of a correlation between the severity of leukoareosis or WMD, urinary symptoms, gait disorder and cognitive impairment. Over the last 20 years, the realization that WMD is not a benign incidental finding in the elderly has become generally accepted and several studies have pointed to an association between geriatric syndromes and this type of pathology. The main brunt of WMD is in the frontal regions, a region recognized to be crucial for bladder control. Other disorders should be excluded, both neurological and urological, such as normalpressure hydrocephalus, progressive supranuclear palsy, etc., and prostatic hyperplasia, physical stress incontinence, nocturnal polyuria, etc. Treatment involves management of small vessel disease risk factors and anticholinergic drugs that do not easily penetrate the blood brain barrier to improve bladder control.
Keywords: geriatric incontinence; white matter change; overactive bladder; vascular incontinence geriatric incontinence; white matter change; overactive bladder; vascular incontinence

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MDPI and ACS Style

Sakakibara, R.; Panicker, J.; Fowler, C.J.; Tateno, F.; Kishi, M.; Tsuyuzaki, Y.; Ogawa, E.; Uchiyama, T.; Yamamoto, T. Vascular Incontinence: Incontinence in the Elderly Due to Ischemic White Matter Changes. Neurol. Int. 2012, 4, e13. https://doi.org/10.4081/ni.2012.e13

AMA Style

Sakakibara R, Panicker J, Fowler CJ, Tateno F, Kishi M, Tsuyuzaki Y, Ogawa E, Uchiyama T, Yamamoto T. Vascular Incontinence: Incontinence in the Elderly Due to Ischemic White Matter Changes. Neurology International. 2012; 4(2):e13. https://doi.org/10.4081/ni.2012.e13

Chicago/Turabian Style

Sakakibara, Ryuji, Jalesh Panicker, Clare J Fowler, Fuyuki Tateno, Masahiko Kishi, Yohei Tsuyuzaki, Emina Ogawa, Tomoyuki Uchiyama, and Tatsuya Yamamoto. 2012. "Vascular Incontinence: Incontinence in the Elderly Due to Ischemic White Matter Changes" Neurology International 4, no. 2: e13. https://doi.org/10.4081/ni.2012.e13

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