Urinary Symptoms and Abnormal Urination in the Elderly
Urinary disorders are one of the common types of problems experienced by the elderly. Almost all seniors will experience some bladder related problem at some time or the other and the likelihood of this increases after the age of 70. However, not all bladder problems are the same and urinary symptoms may overlap among the different disorders. It is therefore important to report these symptoms to a medical doctor and undergo further investigation to identify the exact problem. The use of medication and surgery can subsequently improve symptoms and in some instances totally resolve the condition.
Causes of Abnormal Urination
The human bladder is the reservoir for urine produced in the kidney. When the bladder is full, a person will feel the urge to urinate. Micturition is the process of passing out this urine, commonly referred to as urination, and involves several structures including the muscles of the bladder, around the urethra and the pelvic floor, nerve signals from the lower back and the urethra which directs the urine into the environment. Urinary symptoms may therefore indicate a disorder with one or more of these structures.
In some cases, however, urinary symptoms may be a feature of underlying diseases like kidney failure, diabetes mellitus or the side effects of certain medication.
Types of Urinary Symptoms
There are several types of urinary problems and symptoms. It is therefore important to understand the meaning of these different terms.
- Incontinence, or more correctly urinary incontinence, is involuntary urination. When small amounts of urine are passed out involuntary, a person may not even be aware that they have urinated. Post-micturition dribbling is the passing of a small volume of urine, or several drops of urine, after urination which is not the same as incontinence.
- Urging is the sensation that the bladder is not empty or the feeling to urinate despite having passed urine. It is also known as urinary tenesmus or vesical tenesmus. In most cases a person is able to urinate properly and there is neither excessive nor a deficiency in urination despite the urging.
- Urinary frequency or frequent urination is the passing of stool more frequently than normal. Sometimes it may be the passing of a ‘full bladder’ of urine although in most cases it is the passing of small volumes of urine on a frequent basis.
- Nocturia is awakening at night to urinate or frequent nighttime urination. Although this is not uncommon even when there is no urinary or bladder problem, if it occurs on a frequent basis then it may be an indicate of an underlying disorder. The severity of the condition is partly indicated by how many times a person has to awaken to urinate at night.
- Polyuria is the passage of large volumes of urine. Since the bladder can hold a maximum of about 2 cups of urine, a person may urinate frequently in order to evacuate the excess urine. Therefore urinary frequency will be present.
- Dysuria is any difficulty urinating. The term may also describe painful urination, hesitancy where there is difficulty starting or maintaining the urine stream and straining to urinate.
- Anuria is the absence of urination while oliguria is the passage of very small amounts of urine. These types of urine problems should be weighed out against the total water intake in a day since a person who is not drinking fluids is less likely to urinate.
Understanding these different terms and the nature of the symptom is important in differentiating between normal urinary habits and those abnormalities that may be a symptom of an underlying disease.