Q&A What’s The Matter With Your Bladder?

Q: Are bladder problems a common concern for older people?

A: Yes. Bladder problems are not a common dinner table conversation, but urinary tract infections (UTIs) are one common bladder problem that increases as people age. UTIs are the second most common type of body infection. Every year, UTIs cause 8 million visits to health care providers.

Your urinary tract is your drainage system: it removes wastes and extra water. Your  urinary tract includes two kidneys, two ureters, a bladder, and a urethra. All of us use our bladder many times each day, but many us don’t know how to recognize problems with our bladder function.

A bladder is very much like a balloon. It’s a hollow organ that stores urine. Muscles in the floor of your pelvis help hold urine in your bladder, which is located in your lower abdomen. When you eat or drink, you body can’t use all parts of what you consume.  Your body takes what it needs from foods and drinks, then gets rid of the wastes that are left over.  Your kidneys help remove these wastes and extra water by filtering them out of your blood to make urine. The urine made in the kidneys travels through the ureters to the bladder. The urine is stored in the bladder until you are ready to urinate. When you urinate, the urine exits the body through the urethra.

On a typical day, adults pass about a quart and a half of urine through the bladder and out of the body. That’s the equivalent of four 12 ounce cans of soda. But the exact amount of urine made each day is different for every person. The amount of urine you make depends on how much fluid and foods you take in, how much you lose by sweat, how much you lose from physical activity or breathing, and what medicines you are on.

Your bladder changes as you get older. It becomes tougher, and less stretchy, which means it  can’t hold as much urine, which causes you to go to the bathroom more often. Your bladder wall and pelvic floor muscles also can  weaken, which makes it harder to empty your bladder fully. Weak pelvic floor muscles can also make it hard to hold urine in the bladder, which can cause urine to leak.

These very common bladder problems can impact your quality of life. When people have bladder problems, they may avoid family events or other social settings. They can also make it hard to get tasks done at home or at work. Some of the most common bladder problems include trouble urinating, loss of bladder control, leaking of urine, and frequent need to urinate. The most common type of bladder infection (cystitis) is a urinary tract infection (UTI).  When bacteria (or germs) get into the bladder you can get an inflection, which brings on strong and sudden urges to urinate or having to urinate frequently.

Bladder problems occur more often in women, but they are also quite common in men, who have a prostate gland that surrounds the opening of the bladder. Most tissues get smaller with aging—but the prostate gets bigger. If it gets too big, the prostate can restrict the flow of urine through the urethra. making it hard to start urinating, causing the urine stream to be slow, and preventing men from completely emptying the bladder.

UTIs can happen anywhere in the urinary system, but UTIs are most common in the bladder. Infections in the bladder can spread to your kidneys, or less commonly to your urethra.

Most UTIs are not serious. But some—like kidney infections—can lead to severe problems. Bacteria from a kidney infection can enter your  bloodstream, causing  septicemia—which can be very serious.  Frequent kidney infections can lead to permanent kidney damage, including kidney scars, poor kidney function, and high blood pressure.

If you are unable to hold your urine, or are leaking urine; if you need to urinate eight or more times in 24 hours; if you are waking up many times at night to urinate; if you have sudden and urgent need to urinate or have a weak stream while urinating; if you have pain or burning before, during, or after urinating, or have cloudy or bloody urine; if you are passing only small amounts of urine after strong urges to urinate—these are all reasons to set up an appointment with your doctor.