Aging increases the risk of bladder problems. One in eight people over age 65 will experience a loss of bladder control or other problems with the bladder, according to Tiffany Sotelo, M.D., Assistant Professor of Urology at George Washington University School of Medicine in Washington, D.C. Fortunately, there are a number of lifestyle changes and treatments that can help.
Significance
The most common bladder problem associated with aging is the involuntary release of urine, known as incontinence. This can cause social and psychological problems. "Many seniors with incontinence isolate themselves because they fear having embarrassing accidents," says Sotelo. Incontinence can also lower self-esteem and cause stress, which increases the risk of heart disease, depression and other health problems.
Causes
Aging makes the kidneys work less efficiently and the muscles around the bladder lose strength, according to the National Institute of Diabetes and Digestive and Kidney Diseases. This can cause bladder problems, such as leaking urine. In women, weakened muscles in the pelvic floor due to pregnancy and childbirth can allow the bladder to fall out of position, further contributing to incontinence, says Sotelo. In men, the urethra may become blocked by an enlarged prostate gland, which causes the bladder to function abnormally. Incontinence can also be caused by damage to the nerves that control the bladder from diseases such as multiple sclerosis and Parkinson's disease, notes the National Institute on Aging.
Types
The National Institute on Aging describes four types of incontinence in older people. Stress incontinence is the release of urine when pressure is put on the bladder due to laughing, sneezing, coughing or exercise. Urge incontinence refers to an overwhelming urge to urinate immediately. Overflow incontinence occurs when an obstruction, such as an enlarged prostate gland, causes the bladder to overfill and release urine. Functional incontinence means difficulty getting to the bathroom in time due to mobility issues. Other types of bladder problems that occur in older people include prostate cancer and bladder cancer, says Dr. Sotelo.
Lifestyle Changes
Incontinence can often be helped without medicine or surgery, according to Sotelo. The squeeze-and-hold exercises known as Kegel's can decrease incontinence symptoms by strengthening the muscles used to stop urination. These exercises are often combined with biofeedback and a type of behavior modification known as bladder retraining, says Sotelo. Diet changes, smoking cessation and cutting back on caffeine and alcohol can also be helpful.
Medical Treatments
If lifestyle changes don't do the trick, the next step is prescription medication. Drugs are available that target each type of incontinence, as well as other bladder problems, according to Sotelo. In many cases, medical devices called pessaries will ease incontinence symptoms. Finally, a number of surgical treatments can improve or cure incontinence and other bladder issues. Talk to your primary care doctor, who may refer you to a bladder specialist. "There's no reason to suffer with bladder problems," says Sotelo. "In most cases, they can be eliminated or managed with help from a medical professional."
References
- Tiffany Sotelo, M.D., Assistant Professor of Urology, George Washington University School of Medicine
- National Institute of Aging: Urinary Incontinence
- National Institute of Diabetes and Digestive and Kidney Diseases: Your Urinary System and How It Works
