3-36. GENITOURINARY SYSTEM CHANGES
A number of changes in the genitourinary system occur as the body ages. Look
at these changes.
a. Even without kidney disease, aging causes the kidneys to lose some of their
ability to concentrate urine. With aging, progressively more water is needed to excrete
the same amount of waste. Therefore, it is necessary for older persons to drink more
water than young people. Older people eliminate larger amounts of urine (polyuria)
even at night (nocturia).
b. Beginning at about age 40, there is a decrease in the number and size of the
nephrons. Often, more than 50 percent of the nephrons are lost before age 80.
c. There may be an increase in blood urea nitrogen (BUN) without serious
d. The elderly are more susceptible than young people to infections of the
e. Childbearing may have caused damage to the musculature of the pelvic floor.
Years later, this damage may cause urinary tract problems.
f. Enlargement of the prostate, common in older men, may cause obstruction
and back pressure in the ureters and kidneys. If an enlarged prostate condition is
untreated, it will cause permanent damage to the kidneys.
g. Age changes may predispose a person to incontinence, but age changes do
not cause a person to be incontinent. Most elderly persons (60 percent of those
residing in nursing homes and up to 90 percent of those living independently) have no
All the systems of the body are important. The body has developed the ability to
protect itself by being able to compensate and function well with only one kidney.
Looking at that compensatory mechanism, it is even more devastating when kidney
failure occurs, and the person must rely on dialysis. Early awareness of such problems
can eliminate or prevent many diseases, which attack the kidneys. An individual can
survive without a bladder, but the quality of life will be drastically changed. Use your
assessment skills to obtain early treatment for diseases of the genitourinary system,
preventing those diseases from progressing to more serious levels.