The bladder: Multipathologies and drug interaction in the elderly

Various urological and non-urological diseases, numerous drugs and their relative interactions as well as age related physiological changes may all contribute to mictional disorders in the elderly. This work deals with all the possible causes of age-related vesico-sphincter disorders. Intrinsic age-related changes in the bladder wall, situations related to a change in the cortical control of detrusor function, mictional anomalies secondary to disorders in bladder compliance and urethral function will be analysed. Moreover, the numerous neurological diseases which can determine vesico-urethral dysfunction are briefly considered. Finally, the pharmacological aspects are discussed, including a series of different categories of drugs which influence bladder kinetics, on the one hand determining bladder voiding and filling disorders while, on the other, sometimes permitting a correction of detrusorsphincter functional anomalies.