It is not uncommon to pass urine more frequently in the senior years. This is partly due to age-related changes in the bladder muscle. The bladder may not be completely emptied with urination in these cases and a person urinates more often than usual. However, there are other ways in which bladder function may be affected with age. Sometimes frequent urination is a sign of some underlying disease and therefore needs to be investigated and treated accordingly. Some of these causes of frequent urination can be serious and early diagnosis can play a significant role in treating the condition.
Normal Bladder Habit
A person normally passes out about 2 to 4 pints (about 1 to 2 liters) of urine in a day. The number of times that most people urinate varies and is largely dependent on individual bladder habit. This can range from 3 to 7 times a day in most people. Sometimes urination is more frequent than normal for a person. Although it cannot be clearly defined by the number of times a person urinates, it is marked by passing a higher than normal volume of urine. This is usually around 6 pints (3 liters) or more of urine within a 24 hour period. It is also marked by waking at night to urinate (nocturia) and at times having an incomplete feeling or desire to urinate after having passed urine (vesical tenesmus).
Causes of Urinary Frequency
The bladder fills with small amounts of urine throughout the day. As it fills, the muscular bladder wall stretches. Once the stretching signals become intense when the bladder nears full capacity, there is the urge to urinate. The three most common causes of frequent urination includes :
- Drinking large quantities of water bit by bit throughout the day.
- Cold weather.
- Consuming substances that have a diuretic (water loss) action such as alcohol and coffee.
These causes are not considered to be pathological meaning that urinary frequency is not due to any disease. Some diseases and other factors that may give rise to frequent urination particularly in the elderly includes :
- Medication like diuretics used for water retention and high blood pressure. Other drugs like lithium and radiation exposure for cancer treatment may also be responsible for frequent urination.
- Urinary tract infections which are mainly due to bacteria from the feces invading the urethra and bladder. These infections are more common in women earlier in life but in the senior years it affects men and women equally.
- Diabetes mellitus particularly when it is poorly controlled. Frequent urination is one of the cardinal symptoms of diabetes along with increased thirst.
- Diabetes insipidus where low levels of the hormone ADH (antidiuretic hormone) or commonly known as vasopressin can therefore not prevent the kidneys from expelling large amounts of water.
- Prostate problems in men which may increase the pressure on the bladder or hamper the outflow of urine therefore requiring several episodes of urination to properly empty the bladder.
- Chronic kidney disease where the kidney’s ability to process urine, part of which involves reabsorbing back water into the body, is compromised.
- Urinary stones which are almost always kidneys stones that block the urinary tract at some point and hamper urine outflow either from the kidney to the bladder or from the bladder to the exterior.
- Overactive bladder syndrome is the sudden and uncontrollable contraction of the bladder wall even when the bladder is not full. Sometimes urine may leak even before a person can get to the toilet (incontinence).
- Neurogenic bladder is where problems with the nerves in the bladder causes a person to urinate frequently in small amounts and at time urinate involuntary (incontinence).
- Cystocele in women where the bladder protrudes into the vagina. It is also known as a prolapsed bladder. Vaginal childbirth is one of the main risk factors and by the time menopause is reached, the loss of supportive tissue leads to a prolapsed.
- Vaginal atrophy in women is where the vaginal wall becomes thin and inflamed. It arises in menopause due to the declining female hormone levels. Injury may arise with intercourse and inflammation then persists. Although it is primarily a condition of the vagina, it also affects the bladder due to its close proximity.