Ask the DOCTOR

Q: What are common urinary issues in the elderly?

A: In men, prostate enlargement is common, while women often experience hyperactive bladder or urinary incontinence.

Q: What are the symptoms of prostate enlargement in men?

A: Symptoms may include frequent urination, difficulty starting or stopping urine flow, a sense of incomplete emptying, and, in some cases, urinary retention where urine stops suddenly. Men can have both
prostate enlargement and overactive bladder simultaneously.

Q: What are symptoms of hyperactive bladder in women?

A: Women may experience urgency, frequency, and involuntary leakage of urine, impacting daily life. Underlying diseases can contribute to these symptoms.

Q: How can underlying diseases affect urinary symptoms?

A: Conditions like diabetes or neurological disorders can exacerbate urinary issues, leading to complications and contributing to mental stress.

Q: What are the consequences of urinary problems in the elderly?

A: Social isolation can occur due to the fear of not having a restroom nearby, leading to a loss of confidence.

Q: How can social isolation be a consequence?

A: Fear of unpredictable leaks may cause individuals to avoid social activities, leading to isolation to prevent embarrassment.

Q: What are the reasons for frequent nighttime bathroom visits?

A: Nighttime urination, known as nocturia, can be caused by various factors including ageing, enlarged prostate (in men), urinary tract infections (UTIs), overactive bladder, excessive fluid intake before
bedtime, and underlying medical conditions. Consulting a doctor is advisable for a proper diagnosis and management.

Q: What’s the importance of addressing urinary problems with a doctor?

A: It’s crucial to discuss these issues with a doctor for proper diagnosis, as they can be indicative of underlying health conditions. Since these conditions can be treated effectively, seeking help can
alleviate mental stress and improve quality of life.

Q: Are there preventive measures for urinary issues?

A: Lifestyle changes like maintaining a healthy weight, staying hydrated, and practising pelvic floor exercises can help prevent urinary problems.

Q: What treatments are available for prostate enlargement in men?

A: Treatments may include medications, lifestyle changes, or, in severe cases, surgical intervention to alleviate symptoms.

Q: How is hyperactive bladder treated in women?

A: Treatment options range from lifestyle modifications and pelvic floor exercises to medications and, in some cases, medical procedures, aiming to improve symptoms and mental well-being.

Q: After what time of day should fluid intake be limited?

A: Limit fluid intake, especially caffeinated and alcoholic beverages, in the evening to reduce nighttime bathroom visits.

Q: What foods and fluids should be avoided to manage urinary issues?

A: Avoid spicy foods, caffeine, alcohol, artificial sweeteners as they can exacerbate urinary symptoms and contribute to mental stress, including the risk of urinary retention.

Q: What is urinary retention, and how does it affect the elderly?

A: Urinary retention is the inability to empty the bladder fully. In the elderly, it can lead to symptoms such as difficulty initiating urination, weak urine stream, and increased risk of urinary tract
infections.

Q: How can one differentiate between a urinary tract infection (UTI) and an overactive bladder?

A: UTI symptoms include pain or burning during urination, cloudy or strong-smelling urine, and lower abdominal pain. Overactive bladder symptoms involve a frequent urge to urinate and may cause involuntary
urine leakage. While both can share urgency, UTIs often present with distinctive discomfort during urination and changes in urine appearance. Consulting a healthcare professional for proper diagnosis is
crucial.

Q: How are Benign Prostatic Hyperplasia (BPH), Urinary Tract Infection (UTI), and Overactive Bladder (OAB) diagnosed?

A: BPH Diagnosis: It involves a digital rectal exam (DRE) to assess the prostate’s size and shape, a prostate-specific antigen (PSA) blood test, and imaging studies like ultrasound or cystoscopy.
UTI Diagnosis: A urine sample analysis checks for bacteria and white blood cells. Cultures may identify the specific bacteria causing the infection. Symptoms like pain during urination and frequent urges aid diagnosis.

OAB Diagnosis: Medical history review, symptom assessment (frequent urge to urinate, urgency, incontinence), and ruling out other conditions. Urodynamic tests may be conducted to assess bladder function and rule out underlying issues. Seeking professional evaluation is crucial for accurate diagnosis and tailored treatment.

Q. Can urinary problems in the elderly indicate underlying health issues?
A. Yes, urinary problems in the elderly can serve as warning signs of underlying conditions beyond urinary issues, such as diabetes, kidney disease, or prostate concerns. Seeking medical attention for proper evaluation is crucial for timely diagnosis and management.
Q: Who should undergo prostate screening?
A: Men, especially those aged 50 and older, should consider prostate screening, and earlier for those at higher risk or with symptoms or have family history of prostate diseases. Decisions should be made in consultation with your doctor. Blood test for PSA and ultrasound are the noninvasive screening tools.