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Bladder Control Problems in Old Age People

• 05 Jul,2023
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Are bladder control problems common among elderly individuals? 

Yes, as people get older, they can experience changes in their bladder functioning. To begin with, the elastic wall surrounding their bladder may become more complex and less supple. A less flexible bladder cannot contain as much urine as it once could and thus prompts people to go to the toilet more frequently. Furthermore, their bladder walls and pelvic floor muscles may weaken, making it more difficult for them to empty their bladder. ‘As a result, they could suffer from involuntary pee leakage or urinary incontinence,’ shares Dr. Niren Rao, a urologist in Delhi practising at Delhi Urology Hospital.

What is a urinary bladder and its function?

The bladder is a balloon-shaped, hollow, muscular organ in the lower abdomen. It is a part of the urinary system that also incorporates kidneys, urethra, and ureters. The urinary bladder is situated in the lesser pelvis when empty and can be seen extended into the abdominal cavity when filled with urine. Its primary job is to hold urine, which is then expelled from the body through urination. Urine is the body’s liquid waste and surplus fluid that remains after the intestines separate the essential nutrients from the food and drinks we consume.

If one is suffering from bladder problems in Delhi or one’s parents are suffering from bladder concerns due to old age like bladder incontinence, urinary frequency, urgency, overactive bladder, stress incontinence, mixed incontinence, overactive bladder syndrome, overflow incontinence, nocturia (frequent urination at night), bladder muscle weakness, and neurogenic bladder, they can get all bladder concerns treatment in Delhi with Dr. Niren Rao at Delhi Urology Hospital.

What causes bladder control problems in old age?
 

• Changes in the bladder with advancing age cause bladder control problems 
• The bladder wall's elastic tissue becomes more rigid and less stretchy.
• The urinary bladder is unable to retain as much pee as it used to. 
• The bladder muscles deteriorate.
• There is an increase in involuntary bladder spasms.
• A urethral blockage may occur. In women, this can be caused by weakening muscles, leading the bladder or vag-ina to prolapse. In men, this can be caused by an enlarged prostate gland. Prostate enlargement can increase post-voiding residual volume (50–100 mL) and fluid excretion at night.

What are the types of bladder control problems in old age?
 

• Prostate enlargement: The prostate is a small gland around men's bladder's neck. It can induce voiding symptoms as it grows in size and pushes into the bladder.
• Overactive bladder: The control of urinary bladder functioning becomes more challenging as men and women age. That’s because their bladders may be less capable of storing urine, so they may pass pee more frequently, leading to urinary incontinence.
• Water balance issues: As a person ages, the body finds it more challenging to minimise the volume of urine produced. That’s why elderly people wake up more frequently at night to pass urine. It is, therefore, common for people over 65 to urinate more often at night. Diabetes mellitus, urinary infections, bladder stones, prostate cancer, and neurological disorders are potential causes of LUTS.

Continence concerns might arise in conjunction with other issues

Incontinence in older people typically has an array of causes, including age-related changes to the urinary system. For example, if an older person is experiencing any of the following symptoms, continence difficulties may develop or worsen.

1. Reduced mobility: Reduced mobility can result in falls when attempting to use the restroom. It is the most significant indicator of incontinence, recognized as a high-risk factor for falls in men and women, and a critical contributor to hip fractures in older women.
2. Impaired cognition: Impaired cognition, such as delirium, dementia, and depression, limits a person's capacity to self-toile, especially in an unfamiliar setting. Incontinence may exacerbate the effects of depression.
3. Undernutrition (hydration and fibre): Enough hydration and fibre consumption is required to support bladder and bowel function. Many elderly individuals report reducing their fluid intake to avoid getting up to use restrooms. Such a practice may make them constipated and urge incontinence.
4. Medication side effects (especially diuretics, sedatives, caffeine, and alcohol): Some medicines intake can cause constipation and drowsiness in elderly patients and increase their risk of falling. Diuretics can cause an increase in the frequency of urination. Caffeine and alcohol can irritate the bladder and might increase the frequency of peeing.
5. Skin integrity issues: Coming in contact with urine and faeces can induce skin breakdown. The skin may get vulnerable to friction and pressure damage, dermatitis, and bacterial and fungal infections.
6. Frailty: People who are frail and physically handicapped require washroom facilities that are accessible and safe

How does ageing affect bladder function?
 

Common bladder issues with ageing are:
 

Bladder issues are highly prevalent in old age people. The chances of developing bladder problems are more with increasing age. Common bladder problems associated with ageing include: 

Urinary tract infections (UTIs): Urinary tract infections (UTIs) are the body's second-most prevalent infection. Women are more vulnerable to these infections, with each woman having a 50% chance of developing a UTI throughout her lifetime. Older women have weak bladder muscles, which makes them more susceptible to developing UTIs. Weakening of bladder muscles makes it more challenging for women to empty their bladder, resulting in residual urine remaining in the bladder. If urine is held in the bladder for a long period, there is a high risk of a bacterial infection or UTI. UTIs are classified into three categories:
 

• Bladder infection: The most frequent type of UTI is caused by bacteria entering the bladder. The frequent urge to urinate is a symptom of a bladder infection. 
   
• Kidney infection: Bladder infections can migrate upward and harm the kidneys, resulting in serious complications. Prolonged and repeated kidney infections can cause chronic kidney damage, which is critical. 
   
• Urethra infection: Although less prevalent, an infection can even occur in the urethra.
   

Lower urinary tract symptoms (LUTS): Symptoms of the lower urinary tract are a range of symptoms that include urinating difficulty, lack of bladder control, urine incontinence, and frequent urination. Problems with the urethra, bladder, or pelvic floor muscles could cause these symptoms. 
 

Bladder cancer: It is a form of cancer that develops in the bladder lining. If one is facing bladder issues and looking for bladder treatment in Delhi, one can visit Delhi Urology Hospital.

How can I manage or prevent bladder control problems as I age?

Changes in lifestyle:
 

• Reduce the amount of liquid an elderly person drinks, especially in the evening. If they are experiencing evening symptoms, they should aim to drink as little as possible after 4 p.m. However, do not limit the fluid intake to less than 1.5 litres a day.
• Avoid alcohol, caffeinated drinks (tea and coffee), and smoking, as these affect urine production.
• Try to train your bladder. If individuals frequently desire to pass pee, they should strive to hold it longer. They should progressively increase the time between toilet visits and the amount of urine they pass each time. The bladder muscle can be trained to grow more in this manner.

Along with lifestyle changes, Dr. Niren Rao offers several treatments for bladder issues in Delhi. 
 

• Like pelvic floor muscle exercises to help reduce bladder control problems. These can assist a person in retaining pee for a more extended period.
• Behavioural techniques to manage bladder control issues. 
• Several medications are prescribed that help address specific causes of bladder control problems. These medications may help relax bladder muscles, reduce urinary frequency, or tighten the muscles at the bladder outlet. 
• Certain medical devices like urethral inserts and pessaries are inserted into the urinary tract to support the bladder. 
• Bladder surgery in Delhi is performed to support the bladder or strengthen the muscles controlling urine flow.

To gain more insights, do visit Delhi Urology Hospital to get the best bladder treatment in Delhi with the expert urologist Dr. Niren Rao.