The Effect of Age on Lower Urinary Tract Function: A Study in Women

Authors

  • Mathias H.-D. Pfisterer MD,

    1. From the *Bethanien-Krankenhaus, Geriatric Center of the University of Heidelberg, Heidelberg, GermanyDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Derek J. Griffiths PhD,

    1. From the *Bethanien-Krankenhaus, Geriatric Center of the University of Heidelberg, Heidelberg, GermanyDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Werner Schaefer, PhD,

    1. From the *Bethanien-Krankenhaus, Geriatric Center of the University of Heidelberg, Heidelberg, GermanyDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Neil M. Resnick MD

    1. From the *Bethanien-Krankenhaus, Geriatric Center of the University of Heidelberg, Heidelberg, GermanyDivision of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author

  • This research was supported by United States Public Health Service Grants R01-AG20629 and P01-AG04390. Dr. Pfisterer is funded by the Robert Bosch Foundation, Germany, as a mid-career fellow in geriatrics. An abstract of this study was presented at the 100th Annual Meeting of the American Urological Association in San Antonio, Texas, May 2005, and the Annual Meeting of the Forum Urodynamicum in Munich, Germany, March 2005, where it received the Eugen-Rehfisch Award.

Address correspondence to Dr. med. Mathias H.-D. Pfisterer, Kontinenzberatungsstelle Bethanien-Krankenhaus -Geriatrisches Zentrum-, Rohrbacherstrasse 149, 69126 Heidelberg, Germany. E-mail: mpfisterer@bethanien-heidelberg.de

Abstract

OBJECTIVES: To identify age-associated changes in female lower urinary tract function across a wide age spectrum, controlling for detrusor overactivity (DO).

DESIGN: Secondary analysis of a cross-sectional study of DO and aging. Eligible volunteers were stratified by age group and presence of DO.

SETTING: Community-based volunteers, evaluated in research laboratory.

PARTICIPANTS: Eighty-five ambulatory, nondemented, community-dwelling female volunteers, with and without bladder symptoms suggestive of DO, recruited by advertising, mean age 54 (range 22–90); 75% Caucasian, 21% African American.

MEASUREMENTS: Comprehensive assessment included bladder diary, uroflowmetry, and detailed videourodynamics. Predefined urodynamic and diary variables were examined for association with age and DO. Mean values of these variables were calculated for subgroups aged 20 to 39, 40 to 59, and 60 and older (14 subjects ≥70).

RESULTS: Maximum urethral closure pressure, detrusor contraction strength, and urine flow rate declined significantly with age (P<.001, P<.001, P=.006, respectively), regardless of whether DO was present. Most elderly individuals continued to empty their bladder almost completely, with normal voiding frequency. Mean number of nocturnal voids was less than one in all age groups. Bladder capacity did not decrease with age (mean 522 mL in oldest group) but was smaller in subjects with DO. Bladder sensation diminished significantly with age (P<.001) but was stronger in subjects with DO.

CONCLUSION: Female bladder and urethral function appear to deteriorate throughout adult life, whether DO is present or not. Specifically, detrusor contractility, bladder sensation, and urethral pressure decline. The common belief that bladder capacity shrinks with age may be related to DO rather than to aging itself.

Ancillary