What are the Common Urinary Problems in the Elderly?

As much as many diseases are connected to our lifestyles, there are others that come with age, as our bodies change. A few of them are bladder-related problems. As you get older, your bladder changes. The bladder tissue, for instance, can toughen and become less elastic. This loss of elasticity can mean a lowered capacity to hold as much urine in your bladder as earlier and, consequently, more trips to the bathroom. On the other hand, a weak pelvic floor and bladder walls may make it harder for the bladder to be emptied fully and cause urine to leak.

Common bladder problems

• Urinary tract infection (UTI):
• UTIs are very common infections that can occur in your body. More than 50% of women suffer from a UTI at least once in their lifetime and this infection can occur anywhere in your urinary system. The chances of a UTI increase the longer urine stays in the bladder. This occurs more with age as bladder muscles weaken, making it harder for the bladder to be emptied completely.
• The various kinds of UTIs include:
• - Bladder infection: Bacterial infection in the bladder is the most common kind of UTI. It is most commonly caused by E.Coli, a bacteria found in the gastrointestinal tract. A bladder infection can cause a patient a sudden urge to urinate.
• - Urethra infection: A less common infection, urethra infections occur when bacteria from the gastrointestinal tract enter the urethra. This kind of UTI is more common in women, as their vagina is closer to their anus.
• - Kidney infection:
• - Bladder infections can spread to the kidneys, causing serious problems. Kidney infections that occur frequently or are not eradicated in time can impair kidney function permanently.

• Lower intestinal tract symptoms (LUTS):
• LUTS broadly represent a group of symptoms caused by issues with the urethra, bladder, or pelvic floor muscles.
• Various kinds of LUTS include:
• - Overactive bladder:With age, it becomes harder for older people to store urine in the bladder because of weaker bladder muscles. This can cause frequent urination or even urinary incontinence.
• - Prostate Enlargement:The prostate is situated near the neck of the bladder. When it gets enlarged it can cause problems with coordination between the urethra and bladder muscles, causing problems with urination.
• - Problems with water balance:With ageing, the kidneys begin to lose the capacity to reduce the amount of urine. This can result in increased urination, especially at night. It is normal for the elderly above the age of 65 to urinate more frequently at night.

Other causes of LUTS include urinary infections, bladder stones, diabetes mellitus, neurological conditions, and bladder and prostate cancer.

Symptoms of a urinary problem

Bladders seldom have consistent behaviour. But it is wise to keep an eye out for various symptoms that may signal a urinary problem.

• You are unable to hold urine or frequently leak urine. This is known as urinary incontinence.
• You experience a sudden and strong urge to urinate.
• There is a need to urinate more than 8 times a day.
• You wake up several times in the night to urinate.
• Your urine is cloudy or bloody.
• Only small amounts of urine pass after experiencing a strong urge to urinate.
• There is burning or pain before, during, or after urinating.
• There is trouble urinating or the stream of urine is weak. This can also show as an inability to empty your bladder.

If you experience any of these symptoms, talk to your urologist or your primary doctor.

What tests can diagnose urinary problems?

• Blood sugar is tested to diagnose diabetes mellitus.
• Rectal examination/ prostate examination can detect an enlarged prostate. Your doctor may prescribe further blood tests to rule out prostate cancer.
• Ultrasound of the Kidneys, Ureter and Bladder (KUB) is used to evaluate the urinary tract and check the size of the prostate, residual urine volume, state of the kidneys, and other urinary stone issues.
• Serum prostate-specific antigen (PSA) can be used to measure PSA levels to detect initial markers of prostate cancer. Other PSA-related tests are, however, required to confirm this diagnosis.