Health: Urinary troubles in elderly men

Men are strong physically and tend to dominate the world, when young. But as they grow older, they suffer from many age related problems like stiffness of joints and cataract, visual troubles, e.t.c. But most embarrassing and troublesome of all these problems is the urinary problems. Men have enlargement of the prostate gland with advancing age. This process may begin at around 30 years and become advanced to be clinically manifest by 50 years or even more. Due to the increased growth of the cells of tissue of prostate gland, there is partial or total occlusion of the urethra. This results in difficulty to pass urine and in advanced cases may lead to retention of urine needing urgent intervention. Due to difficulty in passing urine, a man is able to pass only small quantities of urine at a time, thus he has to visit the toilette many times. There is always some residual urine left in the bladder, which makes them prone to infections of the bladder, thus worsening these symptoms. In addition one can have pain in lower abdomen, nausea and vomiting. If there is a malignancy of the prostate, one suffers from similar type of problems. One may have weakness of the urinary bladder due to old age and this results in incontinence of urine, which is very embarrassing for the sufferer. Some of these men have urethral stricture(narrowing of the tube connecting bladder to the outlet for urine) due to diseases like gonorrhea in young age. Due to this they are unable to pass urine easily and have frequent urinary tract infections due to the residual urine. Even after being operated for an enlarged prostate, one can develop urethral stricture. The urethra is dilated mechanically every year or so to help these people. Thus they face the inconvenience and risks of repeated mechanical interventions. Associated hypertension and or diabetes is also present in many of these elderly men. Kidney failure or infections if present due to these conditions can also cause increased frequency of urination and pain in the flanks. If there is derangement of the autonomic nervous system due to diabetes, the gentle man can have urinary incontinence. Drugs like frusemide used to treat heart and kidney failure cause much urination. As it is the elderly who are more on these drugs, they suffer from increased frequency of urination and resultant incontinence. If the individual has suffered a stroke at some time, he can have urinary incontinence after that, which may take time to recover. Surgery is indicated only if there is an enlargement, benign or malignant of the prostate. All other. urinary problems have to be managed conservatively. It is prudent to restrict the amount of fluids taken in case of elderly men who suffer from frequency of urination and incontinence.. Particularly liquids like alcohol, coffee, e.t.c. which produce more urine should be restricted. One should also avoid taking any liquid about 2 hours before bed time to avoid wetting of the bed. An older man with these urinary troubles can also be ,”bladder trained”, as in case of a toddler. Giving liquids at fixed times and going to the toilette at fixed time, helps the bladder to be emptied at fixed intervals, thus avoiding incontinence and troublesome frequency of urination. It is important to keep the individual clean and dry at all times. Urinary catheter is O.K. for some days but keeping a person catheterized for indefinite time is not a good practice. If somebody is able to pass urine voluntarily but finds difficult to reach the wash room, it is better to give him a bed pan. In case of elderly men who are incontinent, a thick soft cotton cloth can be used as a diaper to avoid soiling of the clothes. These men deserve due respect and love like before by their families and should in no way be ridiculed at. The younger men of the family should know that today they are suffering, but tomorrow they will also grow old and can have the same set of urinary problems as these elderly gentlemen. E-mail-rachna212002@yahoo.co.uk