Considering the frequency of urinary disorders in older men, it is not surprising that the majority of urology patients are in their fifties or older. Shrinkage of the kidneys, loss of elasticity and capacity by the bladder, and enlargement of the prostate gland combine to increase the frequency of urination, cause urination to be less complete and bladder control to be lost, as well as other urological disorders. Reductions in the number of functioning excretory units (glomeruli) and, consequently, lower renal blood flow and a lower filtration rate of the kidney's result in body toxins and wastes being excreted less efficiently. Not only is less urine excreted and excreted less efficiently with aging, but it also contains more creatine. Like older men, older women sometimes experience problems with bladder control and incontinence. Urinary problems are not as common in older women as in older men, but cancer of the genitourinary tract is no respecter of gender. Prostate cancer occurs frequently in older men and ovarian or uterine cancer in older women.
Secretions of both male and female sex hormones decline with age, and sexual activity is reduced. The testes shrink somewhat, the cervix and uterus are reduced in size, and the vaginal mucosa atrophies. The incidence of impotence is higher in old age, but many people continue to enjoy a full sex life well into their seventies and eighties (see Chapter 6).
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