As Grandpa said, "What was once wet is now dry, and what was dry now leaks"

Although this may seem like an uncanny expression of the decline of the human body, there is a silver lining. Between ears that don't hear as well, nose sensors that seem blunted, and aches that just don't want to move to their next victim, I am happy to report one thing baby boomers may find they do as well as well as ever: urination. 

In fact, not only are they still doing it, they might be doing it more often than ever. 
A lot more actually.

Now that the kids are grown up, it may surprise you that you are now the one asking to pull over for a pit stop. Although you have trained your kids well, this simply just means that they may have better kidneys, said Dr. Sharon A. Brangman, a professor of medicine at SUNY Upstate Medical University.

People may urinate more as they get older for multiple reasons, including medical problems like diabetes or high blood pressure. Some medicines can be the cause as well. However, it may also be a sign of infection; “That’s often the first thing we look at when people complain of frequent urination,” said Dr. Tomas Griebling, vice chairman of urology at the University of Kansas and a spokesman for the American Urological Association. 

Getting older, Dr. Griebling pointed out, does not necessarily mean more trips to the restroom.  Although many people do notice that they have to go more often, the explanation usually lies with the normal changes of the body.

As people age, their kidneys may become less proficient at concentrating urine and therefore may draw in more water from elsewhere in the body. This means more urine is produced and sent on to the bladder which, as it happens, may be losing some of its ability to stretch. The urethra, the pathway through which the urine exits, may also be shortening and its lining thinning.

Adding to the problem is that with age our bodies produce less of a hormone called aldosterone, that help retain fluid. In women, estrogen levels may also drop, a change associated with increased urination. As for men, the prostate may become bigger making it harder to urinate.

Increased urination knows no time of day, but people seem to notice it more at night due to the inconvenience. In fact, the National Sleep Foundation surveyed people ages 55 to 84, and found that two-thirds of them lost sleep at least a few times a week because of the problem. 

On the up side, talking with your doctor about your increased pit stops may lead to finding an easy fix or get you a stamp for a normal bill of health. 

Is Incontinence Permanent?

In America, 25 million adults suffer from some degree of incontinence, so you might be asking: “Is incontinence permanent?” Incontinence can be uncomfortable, embarrassing, or down right inconvenient. However depending on the the circumstance, but for most, the answer is “no”. Incontinence does not have to be permanent. 

Often diet, medication, and lifestyle impact incontinence, and sometimes making changes can correct temporary incontinence. For example, alcohol and caffeine are bladder stimulants and diuretics, which can lead to the frequent urge to urinate. Certain medications, such as cold medicines, heart medicines, blood pressure drugs, muscle relaxants, and other can lead to temporary incontinence. Urinary tract infections and constipation can also interfere with normal bladder and bowel control. 

Often men who have had prostate surgery will experience temporary incontinence as a result of weakened muscles.Of course, persistent incontinence may be caused by things that are not quite as easily remedied. Pregnancy, aging, menopause, hysterectomy, enlarged prostate, prostate cancer, bladder cancer, bladder stones, neurological disorders, obstructions, and damage to the pelvic floor muscles can all lead to a more permanent form of incontinence.

Pregnancy and childbirth, for example, can lead to hormonal changes, enlarged uterus, stress and weakness on the muscles that control the bladder, can lead to a weakened pelvic floor and often stress incontinence. This may not be totally corrected, but Kegel exercises can help strengthen the pelvic muscles and improve the condition. 

Aging can lead to an increase in overactive bladder symptoms, and weakening of the muscles that control the bowel and bladder. Menopause, a natural part of aging, can also lead to incontinence as a result of hormonal changes.

The only way to know if your incontinence is permanent is to have a medical evaluation with an urological exam and diagnostic work-up. This should be followed up with an individualized treatment plan.

Your physician will likely ask about your symptoms, medications, diet, habits, frequency of urination, how often you leak, what kind of protection you use, what precipitates leaking (sneezing, coughing, running, jumping, etc.), if it is accompanied by constipation. They may ask you to keep a voiding diary.

Treatment Options

A treatment plan will be created with your doctor that may include medications such as alpha blockers, anticholinergies, topical estrogen, imipramine, or duloxetine. In addition treatment will often include stimulating the sacral nerve, treating the prostate, kegel exercises, a male sling, using a bulking agent injected into the urethra, artificial sphincters, urethral plugs.  Lifestyle changes will also be encouraged including fluid and diet management, bladder retraining, and more. 


I encourage you to comment below with a question or a treatment option that you've heard works best.