Introduction
Kidneys remove waste and extra fluid from the body. Kidneys are part of the urinary system. The urinary system involves the kidney, ureter, bladder, and urethra. As individuals age, apart from changes in physiological and cognitive function, the functions of the kidney and urinary bladder get affected.
What Is Urologic Health?
Urologic health includes the health of the urinary tract, like the kidneys, ureters, bladder, and urethra, in both males and females. It also deals with male organs like the penis, testes, scrotum, and prostate. Health problems related to these organs can affect anyone. Hence, urologic health is important.
Urologic problems are more commonly seen among the elderly (geriatric population). Urologic disorders seen among older people are not normal, but they are not inevitable as age advances. Urologic disorders include urinary incontinence, urinary tract infections, sexual dysfunction, and urologic malignancies like kidney, bladder, and prostate cancer.
The geriatric population has a rapid rise compared to other age groups. Hence, there is a need for the care of geriatric patients to improve their quality of life during old age.
What Are the Impacts of Aging on Urologic Health?
Many physiological and behavioral changes can be observed in older individuals. Apart from these changes, urological changes can also be observed.
These include
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Decreased kidney function, which includes reduced blood flow and the ability to filter.
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Decreased capacity, weakened muscles, and reduced sensitivity.
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Inflammation of the urethra, due to which there is a restricted urinary flow.
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Reduced urine flow due to enlarged prostate.
Experiencing one or more of these problems may lead to urination changes. Muscle and reproductive system changes may change the bladder's function.
Age changes observed in kidneys include
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Due to a decrease in kidney tissue, kidney function is affected.
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Decrease in nephrons (filtering units).
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Due to the hardening of the blood vessels in the kidney, the function of filtering gets slowed down.
Age changes observed in the bladder include
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Changes in the bladder wall can be observed. The elastic tissue of the bladder gets stiffer, and hence the bladder becomes less stretchy.
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The muscles in the bladder get weakened.
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The urethra gets partially or completely blocked.
In a healthy aging person, the functioning of the kidneys diminishes slowly, but in individuals with chronic diseases, medications may show marked degradation in the function of the kidney.
Some of the common urinary problems among the elderly include
- Urinary Incontinence: This condition is characterized by the leakage of urine accidentally. There are three types of urinary incontinence. Leakage of urine is due to stress on the bladder, mainly due to coughing, laughing, exercising, etc. In urge incontinence, urine leakage occurs as the bladder cannot accommodate it, and urinating is urgent. In overflow incontinence, leakage occurs from a full bladder.
- Urinary Tract Infections: This condition can be observed due to incomplete bladder voiding. Hence, there is an increased risk of urinary tract infections.
- Benign Prostatic Hyperplasia: In this condition, the prostate gland swells in men. This condition is considered non-cancerous. Frequent urination can be observed among older individuals.
- Kidney Stones: These are hard and formed due to mineral deposits in the kidneys. These are called nephrolithiasis, urolithiasis, and renal calculi.
- Bladder Cancer: This condition usually begins in urolithial cells. These cells line the inside of the bladder. Urolithial cells are present in the kidneys and ureters too.
Changes in patterns of urination can be observed among old-aged individuals. The following changes can be seen:
- Increased Frequency of Urination: This condition may be caused by anatomy changes or medications used.
- Nocturia: This condition is characterized by awakening at night to urinate.
- Urinary Urgency: Some changes in the urinary tract may immediately create the sensation of urinating.
- Urinary Retention: This condition may occur due to the inability to empty the bladder. It is a common condition.
- Difficulting in Starting Urination: Individuals of old age may struggle to start urinating. They may take a longer time to begin urinating.
- Weak Urine Stream: The urine flow may be reduced if an individual is affected by benign prostate hypertrophy.
These changes must be observed and notified to prevent them from disrupting an individual's lifestyle.
How to Diagnose Urologic Changes?
The diagnosis of urologic changes can be made through the following tests.
Imaging Tests:
- CT Scan: Computed tomography (CT) scans, along with X-rays, help determine 3-dimensional views of soft tissues in the adrenal glands, kidneys, pelvis, and prostate glands.
- Intravenous Pyelogram: X-rays and injectable dye are used to check the functioning of the urinary tract. This procedure helps to know the movements of the kidneys, ureters, and bladder.
- Magnetic Resonance Imaging (MRI): In this test, magnets and radio waves create images of parts of the urinary tract, pelvic areas, prostate, and vagina.
- Ultrasound: Ultrasound helps record sound waves that bounce off soft tissue surfaces and internal structures. This helps in forming a moving, 3-dimensional picture of the urinary tract.
Laboratory Tests:
- Blood Tests: This helps determine certain conditions like infections, hormonal disorders, cancers, etc. Other tests include prostate-specific antigen tests, sperm count analysis, stone analysis, urine culture, etc.
Minimally Invasive Tests:
- Biopsy: This is done to determine conditions like cancer and renal failure. Other tests include bladder function tests, cystoscopy, and an MRI-ultrasound fusion prostate biopsy.
Other Tests:
- Digital Rectal Exam: A gloved finger is used to examine the rectum.
- Penile Injection: Medication is injected into the penis to check for an erection. With this test, blood flow problems can be identified.
How to Treat Urological Diseases?
Urologic diseases can be treated with medications, devices, and surgery, along with changes in lifestyle, exercises, and behavioral training. A combination of methods can be used to treat urological diseases. There are many ways to address these problems and help improve comfort, control, and confidence.
Conclusion
Urologic health gets affected in old age, but these people need not live with it. There are many ways to overcome these problems, which can be prevented by changing their lifestyle, practicing exercises, and training their behavior.
