As men grow older, bladder function can worsen and the prostate gland may be responsible

Mayo Clinic researchers studying prostate problems in men report in the current issue of the Journal of Urology that as men grow older their bladder function can worsen and the prostate gland may be responsible.

Their findings remind patients and their physicians that urination difficulties in men can be better cared for at early onset. Additionally, the study notes that as men age, the possibility increases that they will experience problems with urination.

"What we know is that many men ignore their symptoms and do not seek assistance with their physician until much later," said Andrew Rule, M.D., nephrologist and epidemiologist at Mayo Clinic and the lead author of the study. "What happens is men can end up with a bladder not working, perhaps needing a bladder catheter all the time. They also become at increased risk for bladder infections and even kidney failure problems."

The researchers looked at information in men from two tests: post-void residual and voided volume. The post-void residual test involved men urinating and then having an ultrasound scan to determine how much urine remained in the bladder. The voided volume test measured how much urine men could void with a full bladder.

Dr. Rule said that both tests are difficult to interpret in a patient because they can yield varying results with the same person each time. However, because the study relied on hundreds of men with multiple visits, those variations could be lessened. The study looked at a random sample of 529 men, ages 40 to 79, who were followed with the two tests every two years for up to 12 years.

Dr. Rule says the study presents some new data on the natural history of the post-void residual and void volume in men as they age.

"What was interesting is that as men aged, their post-void residual increases but eventually levels off," he says. "On the other hand, voided volume decreased as men aged and did so at an increasingly rapid rate. These findings were consistent with the development of a stiff, weak and overactive bladder in men as they age."

Not all men were at equal risk for these changes to occur. "Men with signs or symptoms of a prostate obstruction were more likely to have worsening bladder function," said Dr. Rule. "It isn't necessarily prostate cancer, but the prostate's enlargement with aging that gives men greater problems in urinating."

He advises patients to consult their physicians if they notice changes in their urination such as a slow stream, straining, and the feeling of not being able to empty their bladders. Also, having to urinate frequently or multiple times at night deserves a visit to the doctor. Medications and surgical options for treating prostate obstruction can preserve bladder function.

The research team also included: Debra Jacobson, Michaela Mc Gree, Cynthia Girman, Dr. P.H., Michael Lieber, M.D., and Steven Jacobsen, M.D., Ph.D., all of Mayo Clinic.

http://www.mayoclinic.org/