Urological health: How to care for your urinary system at every age

Our urinary health evolves over time, and understanding how it changes can help us to take preventive measures and seek early medical attention when needed.

Mr Roland Morley, distinguished consultant urological surgeon, provides an expert insight into common urological problems and offers practical advice on how to care for our urinary health at every stage of life.

What are common urological problems in our 20s and 30s?

While our 20s and 30s are generally a time of peak health, our urinary system is still prone to certain issues, such as urinary tract infections, kidney stones, and sexually transmitted infections.

To maintain urological health, it’s thus important to prioritise hydration, practise safe sex, and avoid holding urine for prolonged periods. Drinking plenty of water can help prevent kidney stones and UTIs, while regular check ups with a specialist, such as a consultant urologist, can help detect and address any emerging issues early.

What changes can I expect as I reach my 40s and 50s?

As we enter our 40s and 50s, hormonal changes, muscle weakening, and the natural ageing process can result in urological changes.

For example, it’s common to notice an increase in the frequency of urination during this time. You may find yourself needing to urinate more often during the day.

As the muscles that support the bladder weaken with age, you may also experience stress urinary incontinence, where activities like coughing, laughing, or sneezing cause urine leakage. This is more common in women due to childbirth, but it can affect men as well.

In our 40s and 50s, how does the menopause affect a woman’s urinary health? How does prostate health affect men?

Women’s health

During the menopause, oestrogen levels decrease, causing several issues such as vaginal dryness and urogenital atrophy.

Additionally, the drop in oestrogen leads to the thinning and drying of vaginal and urethral tissues, which increases the risk of urinary tract infections and problems with bladder control. Another prevalent issue is urinary incontinence, which can present as either stress incontinence or urge incontinence (sudden and intense urge to urinate).

Pelvic floor exercises are commonly recommended to strengthen the muscles that support the bladder and enhance bladder control.

Men’s health

With age, the prostate gland may enlarge, a condition referred to as benign prostatic hyperplasia (BPH). While BPH isn’t cancerous, it can cause troublesome urinary symptoms.

For example, one common symptom is frequent urination, with men often feeling the need to urinate more frequently, especially at night. Another issue is difficulty starting urination, as the enlarged prostate can press against the urethra, making it harder to begin urinating or causing a weak urine stream. Additionally, men with BPH may experience incomplete emptying of the bladder, leading to residual urine and an increased risk of urinary tract infections.

Regular prostate exams and PSA tests are important for monitoring prostate health and detecting potential issues early.

How can I manage urinary incontinence in my 60s and beyond?

By the time we reach our 60s and beyond, the risk of developing urological problems grows, making regular screenings and proactive management of urinary problems increasingly important. Several strategies are available to help issues like urinary incontinence.

For example, pelvic floor exercises can help strengthen the pelvic muscles and enhance bladder control, especially in cases of stress urinary incontinence. Bladder training, which involves gradually increasing the time between urinations, is another effective method, especially for overactive bladder or urge incontinence.

In certain situations, medications that relax the bladder or enhance muscle function may be prescribed. For more severe cases, surgical options such as bladder slings or artificial urinary sphincters might be considered. Additionally, lifestyle adjustments, such as reducing caffeine and alcohol intake, losing weight, and managing chronic conditions like diabetes, can help alleviate incontinence symptoms.

What screenings should I undergo to maintain urological health as I age?

Regular screenings are crucial for the early identification of potential urological problems. Some key screenings you should consider as you age include:

• Prostate exams for men: Starting in your 50s, or earlier if you have a family history of prostate cancer, regular prostate exams and PSA tests are recommended. These screenings can help detect prostate cancer and BPH at an early stage.
• Kidney function tests: As we age, kidney function can decline, leading to chronic kidney disease. Regular blood and urine tests can help monitor kidney health and identify any decline in function.
• Bladder cancer screening: People with a history of smoking, frequent bladder infections, or exposure to industrial chemicals are advised to consider regular bladder cancer screenings. Blood in the urine (haematuria) is an early warning sign of bladder cancer.
• Pelvic exams for women: Women should continue with routine pelvic exams and urinary health assessments, especially if they experience incontinence, recurrent UTIs, or pelvic organ prolapse.

If you would like to book an appointment, head on over to Mr Roland Morley's Top Doctors profile today.