Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40; B—41 to 50; C—51 to 60; D—61 to 70; E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p < 0.05). Moreover, mathematical equations were presented to estimate the parameters values in relation to age. Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.
References
[1]
Dos Santos, F., Andrade, V.M. and Bueno, O.F.A. (2009) Aging: A Multifatorial Process. Psicologia em estudo, 14, 3-10.
https://doi.org/10.1590/S1413-73722009000100002
[2]
Kenny, G.P., Groeller, H. and McGinn, R. (2016) Age, Human Performance, and Physical Employment Standards. Applied Physiology, Nutrition, and Metabolism, 41, 92-107. https://doi.org/10.1139/apnm-2015-0483
[3]
Biehl, M., Takahashi, P.Y. and Cha, S.S. (2016) Prediction of Critical Illness in Elderly Outpatients Using Elder Risk Assessment: A Population-Based Study. Clinical Interventions in Aging, 11, 829-834.
[4]
Baumann, C.W., Kwak, D. and Liu, H.M. (2016) Age-Induced Oxidative Stress: How Does It Influence Skeletal Muscle Quantity and Quality? Journal of Applied Physiology, 121, 1047-1052. https://doi.org/10.1152/japplphysiol.00321.2016
[5]
Steptoe, A., Deaton, A. and Stone, A.A. (2015) Subjective Wellbeing, Health, and Ageing. The Lancet, 385, 640-648. https://doi.org/10.1016/S0140-6736(13)61489-0
[6]
Greenwood, H. and Bartlett, D.B. (2013) Meeting Report: British Society for Research on Ageing (BRSA). Annual Scientific Meeting 2012, Vol. 2, Birmingham, 3-4 July 2012, 6. https://doi.org/10.1186/2046-2395-2-6
[7]
Araki, I., Zakoji, H. and Komuro, M. (2003) Lower Urinary Tract Symptoms in Men and Women without Underlying Disease Causing Micturition Disorder: A Cross-Sectional Study Assessing the Natural History of Bladder Function. The Journal of Urology, 170, 1901-1904. https://doi.org/10.1097/01.ju.0000092942.87643.27
[8]
Madersbacher, S., Pycha, A. and Kringler, C.H. (1999) Interrelationships of Bladder Compliance with Age, Detrusor Instability, and Obstruction in Elderly Men with Lower Urinary Tract Symptoms. Neurourology and Urodynamics, 18, 3-15.
https://doi.org/10.1002/(SICI)1520-6777(1999)18:1<3::AID-NAU2>3.0.CO;2-4
[9]
Aggarwal, H. and Zimmern, P.E. (2016) Underactive Bladder. Current Urology Reports, 17, 17. https://doi.org/10.1007/s11934-016-0582-6
[10]
Lachowsky, M. and Nappi, R.E. (2009) The Effects of Estrogen on Urogenital Health. Maturitas, 63, 149-151. https://doi.org/10.1016/j.maturitas.2009.03.012
[11]
Nelson, H.D. (2008) Menopause. The Lancet, 371, 760-770.
https://doi.org/10.1016/S0140-6736(08)60346-3
[12]
Bump, R.C., Mattiasson, A., Bo, K., Brubaker, L.P., DeLancey, J.O., Klarskov, P., et al. (1996) The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction. American Journal of Obstetrics & Gynecology, 175, 10-17. https://doi.org/10.1016/S0002-9378(96)70243-0
[13]
Bansal, R., Agarwal, M.M. and Modi, M. (2011) Urodynamic Profile of Diabetic Patients with Lower Urinary Tract Symptoms: Association of Diabetic Cystopathy with Autonomi and Peripheral Neuropathy. Urology, 77, 699-705.
https://doi.org/10.1016/j.urology.2010.04.062
[14]
Pfisterer, M.H., Griffiths, D.J. and Schaefer, W. (2006) The Effect of Age on Lower Urinary Tract Function: A Study in Women. Journal of the American Geriatrics Society, 54, 405-412. https://doi.org/10.1111/j.1532-5415.2005.00613.x
[15]
Zimmern, P., Litman, H.J. and Nager, C.W. (2014) Effect of Aging on Storage and Voiding Function in Women with Stress Predominant Urinary Incontinence. The Journal of Urology, 192, 464-468. https://doi.org/10.1016/j.juro.2014.01.092
[16]
Shin, Y.S., On, J.W. and Kim, M.K. (2015) Effect of Aging on Urodynamic Parameters in Women with Stress Urinary Incontinence. Korean Journal of Urology, 56, 393-397. https://doi.org/10.4111/kju.2015.56.5.393
[17]
Yang, J.M. and Huang, W.C. (2003) Factors Associated with Voiding Function in Women with Lower Urinary Tract Symptoms: A Mathematic Model Explanation. Neurourology and Urodynamics, 22, 574-581. https://doi.org/10.1002/nau.10086
[18]
Gilmour, R.F., Churchill, B.M. and Steckler, R.E. (1993) A New Technique for Dynamic Analysis of Bladder Compliance. The Journal of Urology, 150, 1200-1203.
[19]
Toppercer, A. and Tetreault, J.P. (1979) Compliance of the Bladder: An Attempt to Establish Normal Values. Urology, 14, 205.
https://doi.org/10.1016/0090-4295(79)90164-X
[20]
Abrams, P. (1999) Bladder Outlet Obstruction Index, Bladder Contractility Index and Bladder Voiding Efficiency: Three Simple Indices to Define Bladder Voiding Function. BJU International, 84, 14-15.
https://doi.org/10.1046/j.1464-410x.1999.00121.x
[21]
Wahl, E.F., Lahder-Vasama, T.T. and Churchill, B.M. (2003) Estimation of Glomerular Filtration Rate and Bladder Capacity: The Effect of Maturation, Ageing, Gender and Size. BJU International, 91, 255-262.
https://doi.org/10.1046/j.1464-410X.2003.04053.x
[22]
Pfisterer, M.H., Griffiths, D.J., Rosenberg, L., Schaefer, W. and Resnick, N.M. (2007) Parameters of Bladder Function in Pre- , Peri- , and Post-Menopausal Continent Woman without Detrusor Overactivity. Neurourology and Urodynamics, 26, 356-361. https://doi.org/10.1002/nau.20381
[23]
Pfisterer, M.H., Griffiths, D.J., Rosenberg, L., Schaefer, W. and Resnick, N.M. (2006) The Impact of Detrusor Overactivity on Bladder Function in Younger and Older Women. Journal of Urology, 175, 177-183.
https://doi.org/10.1016/s0022-5347(05)00985-7
[24]
Schultens, A., Becker, T., Balmer, D., Seidilová-Wuttke, D. and Wuttke, W. (2004) In Vivo Properties of the Urinary Bladder Wall and Their Modulation by Estradiol and Raloxifene in a Rat Model. Experimental and Clinical Endocrinology & Diabetes, 112, 514-519. https://doi.org/10.1055/s-2004-821314
[25]
Lowalekar, S.K., Cristofaro, V., Radisavljevic, Z.M., Yalla, S.V. and Sulivan, M.P. (2012) Loss of Bladder Smooth Muscle Caveolae in the Aging Bladder. Neurourology and Urodynamics, 31, 586-592. https://doi.org/10.1002/nau.21217
[26]
Schueth, A., Spronck, B., van Zandvoort, M.A. and van Koeveringe, G.A. (2016) Age-Related Changes in Murine Bladder Structure and Sensory Innervation: A Multiphoton Microscopy Quantitative Analysis. Age, 38, 17.
https://doi.org/10.1007/s11357-016-9878-1
[27]
Tseng, L.H., Liang, C.C., Tsay, P.K., Wang, A.C., Lo, T.S. and Lin, Y.H. (2008) Factors Affecting Voiding Function in Urogynecology Patients. Taiwanese Journal of Obstetrics and Gynecology, 47, 417-421.
https://doi.org/10.1016/S1028-4559(09)60009-7