Urinary tract disorders

The overall incidence of urinary tract infection (UTI) rises with increasing age. Factors involved include incomplete bladder emptying, and the increased use of antibiotics and catheters. ¹ The frail elderly may also be more prone to infections caused by less virulent organisms than younger people (see p. 12). It is associated with faecal incontinence, probably secondary to perineal soiling. ¹ UTI is 40 times more common in young women than young men. ² A key factor in this difference is thought to be the shorter length of the urethra and the closer proximity of its meatus to the anus. Half of all women have a least one UTI in their lifetime. ² However, this gender gap becomes narrowed in later life and is reported to be almost as common in men as in women over the age of 75. ³ This is thought to be due to the development of benign prostatic hyperplasia (BPH) in men, in some cases causing bladder outflow tract obstruction and urinary retention. ⁴ The insertion of urinary catheters is another strong risk factor for the development of UTI, and occurs more commonly in older adults (see later).