Older adults commonly experience bothersome symptoms related to urination, which may be different for men and women.
 
Incontinence

• Incontinence, which is the bladder’s inability to hold urine, can be total, partial, or occasional. There are many reasons for incontinence, including neurological factors from conditions like dementia, and medications such as diuretics. Additionally, there are different types of incontinence.
• Stress incontinence is the loss of bladder control when there is increased abdominal pressure, such as when coughing, sneezing, or even standing. Many women who have had multiple pregnancies or other pelvic procedures may experience stress incontinence more easily. This problem can significantly limit quality of life and lead to social isolation and even depression. Pelvic floor exercises and other measures to reduce abdominal pressure may help, and some individuals may benefit from corrective surgery.
• Urge incontinence is characterized by difficulty controlling the bladder as soon as the urge to urinate is felt. This condition often leads to frequent urination due to an inability to hold a large volume of urine at any given time. Both older men and women may experience varying degrees of this issue, often because of oversensitive bladder muscle signaling. Many individuals suffer from poor sleep due to frequent nighttime urination. There are medications that may help with bladder control for longer periods, but some may cause side effects, such as confusion in dementia patients, so physicians should be closely consulted before starting them.

• Prostate enlargement, which leads to increasing difficulty in passing urine, is an issue most older men will face as they age, sooner or later. Symptoms may initially present as increased frequency of urination, particularly at night, but can progress to a slow or dribbling stream, ultimately resulting in an almost total inability to pass urine. There are many treatment options available for prostate enlargement, including medication and various surgical procedures, which can be discussed with a urologist.
• Less commonly, the symptoms of prostate enlargement may be due to prostate cancer. Older men should discuss screening for prostate cancer with their doctors.
• Older adults of both sexes can also experience urinary retention for other reasons, often occurring in those who are more immobilized and frail, as their ability to completely empty the bladder becomes more difficult. This can lead to frequent urinary tract infections or worsening kidney function. Some individuals may require intermittent or permanent catheterization as a solution.

Urinary tract infections (UTIs) are a common problem experienced by older adults. Factors such as aging, drier outer skin, weakened immune defenses, and difficulties in passing urine can all contribute to the occurrence of UTIs. Some older adults may not exhibit the classic symptoms of infection—such as burning or stinging during urination, increased urinary frequency, or fever. Instead, they may present with increased confusion, drowsiness, or even complete incontinence. While some mild infections may resolve on their own or improve with increased fluid intake, a doctor should be consulted if symptoms persist for appropriate antibiotic treatment.