LUTS in the Older Adults

Introduction

Lower urinary tract symptoms (LUTS) describe storage problems associated with urination. These symptoms include frequency, urgency, urination, and post-voiding problems. The storage symptoms negatively affect one’s quality of life. LUTS affect both biological genders as they age. Voiding dysfunction is due to changes in bladder function and increased comorbidities with multiple medications causing adverse effects to the bladder. This blog will discuss LUTS-associated aging.

LUTS Associated with Again

There is a double impact on LUTS symptoms and aging, and those seeking treatment for LUTS are low. LUTS symptoms with aging increase with functional impairment, environmental factors, and multiple comorbidities. Bladder changes with aging are associated with reduced bladder capacity, increased sensitivity to neurotransmitters, impaired contractility, decreased urinary flow and increased post-residual void volumes.

Storage Problems

  • Frequency: Frequency is urinating eight times per day or more.
  • Nocturia: Nocturia is waking up one or more times during the night due to the urge to urinate. Nocturia in aging adults is related to changes in antidiuretic hormone levels.
  • Urgency: Urgency is described as the overwhelming need to urinate due to pain or an unpleasant sensation that causes difficulty delaying urination. Urgency may also cause incontinent episodes.
  • Overactive bladder (OAB): OAB is the frequency of urination with urgency or nocturia. OAB reduces the ability to delay voiding. In addition, changes in increased collagen in the bladder wall reduce elasticity and bladder capacity.
  • Voiding stream: The stream may be slow, interrupted stream, terminal dribble, hesitancy, or straining. The decrease in the stream is caused by reduced bladder contraction failing to empty the bladder completely.
  • Post-micturition: After voiding, there may be a sensation of incomplete emptying, dribbling, or incontinence. Reduced elasticity, bladder capacity, and reduced M3 receptors affect muscle contractility. This leads to ineffective bladder emptying and higher postvoid residual volumes.

Other Variables

  • Obesity: An overweight adult’s body mass index (BMI) is between 25-29.9. A BMI of 30-34.9 is obese, and 35 or higher is severely obese.
  • Alcohol consumption: Five alcoholic drinks per week or more can cause health problems such as urinary retention and neuropathy.
  • Polypharmacy: Six medications or more per day. Comorbidities can cause polypharmacy.
  • Gender-specific changes: Enlarged prostate in males or estrogen loss in women causing a reduction in urethral closing pressures and urethral length.
  • Comorbidities: Studies have indicated comorbidities such as hypertension, heart disease, diabetes, and dyslipidemia cause pelvic ischemia. Pelvic ischemia plays a role associated with LUTS.

Conclusion

Voiding dysfunction and incontinence are not a natural part of aging and are treatable. Aging affects continence by alteration in cognitive status, mobility, and dexterity. Therefore, evaluating older adults is essential for developing a treatment plan for elderly patients with LUTS. In addition, the understanding of LUTS in aging is continually evolving.

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