Men’s Most Common Urinary Issues Facing 50’s

Advancing age is known to affect the integrity and health of all biological tissues; thereby aggravating the risk of a variety of disorders and illnesses in individuals. It is imperative to mention that immune defense mechanisms of the body also declines with physiological aging, which is why healthcare professionals recommend more periodic examinations after 50 years of age.

Most common urinary issues that are faced by males after 50 years of age are:

1. Prostate gland Inflammation: Prostatitis (or inflammation of prostate gland) is a common complaint in middle-aged to elderly males that can present with symptoms like:

• Back pain
• Fever
• Increased frequency of urination
• Increased urgency of urination
• Persistent and gnawing groin pain

In case if you experience these symptoms, talk to your doctor right away. The most common cause of prostatitis is accumulation of bacteria; due to benign prostate hyperplasia.

Most mild cases of acute bacterial prostatitis are managed by pharmacological agents (such as antibiotics); however, in advanced cases or severe infection, most aggressive regimen should be followed to prevent the risk of serious complications.

2. Benign Prostatic Hypertrophy/ Hyperplasia:

Mild to moderate enlargement of prostate gland is fairly common in middle-aged males. The most common presenting complaint in the setting of BPH is; changes in the urinary flow and poor stream formation that may interfere with the complete voiding of urinary bladder. Retention of urine in the bladder can aggravate the risk of recurrent urinary tract infection, prostatitis and a variety of other urinary issues.

3. Prostate Cancer:

Malignancy of prostate gland is the third most frequently diagnosed cancer in males that claims approximately 21.4 lives per 100,000 males. According to latest statistics, lifetime risk of developing prostate cancer in males is 14%.

Classic symptoms of prostate cancer are:

• Onset of blood in the urine
• Weight loss
• Back pain
• Changes in urinary urgency and frequency

Most common risk factors that are implicated in the setting of prostate cancer are; history of smoking, family history of prostate and other malignancies and chronic exposure to rubber, dye and industrial chemicals as part of the occupational hazards.

Other malignant lesions that are also reported in males over 50 years of age are; testicular carcinoma, bladder malignancy.

4. Bladder related conditions – Incontinence:

Bladder’s muscular wall changes are common as part of aging process and can adversely affect the tone and strength of bladder musculature; thereby leading to incontinence of urine. According to latest statistics, at least one of every three males experience some degree of urinary incontinence after 50 years of age.

There are two classic varieties of incontinence; these are:

• Urge incontinence: A sudden, uncontrollable and overpowering urge to urinate that is abruptly followed by incontinence
• Overflow incontinence: This variety is more common in older males with chronic diabetes or nerve dysfunction and is classically marked by leakage of urine due to overfilling of bladder.

Incontinence can be managed via home remedies, lifestyle modifications and pharmacological interventions.

5. Sexual or Erectile dysfunction:

Erectile disorders are fairly common after 50 years of age. According to latest statistics, at least one of every four males over the age of 60 years report some degree of erectile dysfunction. Individuals with chronic or poorly managed health issues (such as cardiovascular disorders, diabetes, multiple sclerosis, liver dysfunction, alcoholism etc.) are more vulnerable to develop ED.

Part of these issues are attributed to andropause (or age related decline in serum testosterone levels).

What to do if you are experiencing urological conditions in your 50’s?

If you are experiencing disturbing urinary symptoms that are compromising the quality of your life and relationships; it is strongly recommended to see a healthcare professional for proper evaluation. Your urologist or healthcare professional may advice one or more of the following tests to identify the primary disorder for proper evaluation:

• Physical exam: General physical examination in middle-aged to elderly males include a comprehensive digital rectal examination to assess the shape, size, borders and edges of the prostate gland.
• Urine Analysis: Healthcare professionals advise urine analysis to identify/ diagnose and confirm the source/ origin of the infection.
• Flow-rate assessment: This test is required to assess the speed or flow of urine to confirm BPH.
• Ultrasound: Ultrasound of pelvis is advised to assess kidneys and urinary system to check the site, source and extent of urinary blockage.
• Urodynamics: This is a series of test that is performed to check the functioning of urinary system.

References

1. www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-survival-rates

2. Moyer, V. A. (2012). Screening for prostate cancer: US Preventive Services Task Force recommendation statement. Annals of internal medicine, 157(2), 120-134.

3. Foley, A. L., Loharuka, S., Barrett, J. A., Mathews, R., Williams, K., McGrother, C. W., & Roe, B. H. (2012). Association between the Geriatric Giants of urinary incontinence and falls in older people using data from the Leicestershire MRC Incontinence Study. Age and ageing, 41(1), 35-40.

4. McVary, K. T., Roehrborn, C. G., Avins, A. L., Barry, M. J., Bruskewitz, R. C., Donnell, R. F., … & Wei, J. T. (2011). Update on AUA guideline on the management of benign prostatic hyperplasia. The Journal of urology, 185(5), 1793-1803.