Unit 15
Both women and men have physical changes in their genitourinary system in aging.
Women tend to have a weakened sphincter where the urethra and bladder meet. This makes it difficult to hold the urine in causing small leaks when sneezing, coughing or any other pressure in the area. This is called stress incontinence. This resident may need a pad placed in their underwear to prevent soiling their clothing. If the pad is not changed frequently after a leak bacteria can grow causing irritation or infection.
Women also tend to get a prolapsed bladder, this is when the bladder slumps over in the abdomen resulting in urinary retention and can lead to a bladder infection (cystitis) also called a UTI (urinary tract infection).
Men tend to develop BPH as they age. BPH (benign prostate hypertrophy) is when the prostate becomes enlarged and presses up against the urethra pinching off the urine flow. This causes urine to back up and the bladder becomes overfilled and painful. When enough pressure builds a weak stream of urine comes out but stops after the pressure drops leaving the remaining urine in the bladder. This can cause frequent small amounts of urination and bladder infections.
Men can also develop prostate cancer in older age. Some types are slow growing and, depending on the risk vs benefit, they may choose not to treat it. Other types of prostate cancer are aggressive and fast growing resulting in the need to surgically remove the prostate which can have many side effects including incontinence. Chemotherapy and radiation can also be part of the treatment.
Understanding this and assisting the resident to the toilet frequently, helping the resident chose pants that are easy to pull down, and having a urinal at the bedside can help a resident cope with these symptoms.
While this video is actually from the CMA course, I believe it helps to better understand the anatomy.