Renal and Lower Urinary Tract Disorders in the Elderly

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk


Numerous anatomical and physiological changes occur with ageing, resulting in reduced blood flow, reduced glomerular filtration rate and impaired renal autoregulation. There is decrease in tubular length and size of the proximal tubular epithelial cells. The normal regulatory mechanisms (renin-angiotensin pathway, aldosterone antidiuretic hormone) are depressed, and levels of aldosterone, renin activity and serum renin levels are low in older persons. Glomerular disease may be primary or secondary in the ratio of 7:3 in elderly patients. Renovascular diseases (RVD) that causes end-stage renal disease include inflammatory vasculitis, nephrosclerosis, RVD atherosclerosis and embolic disease. Acute kidney injury (AKI) comprises three main categories: pre-renal, renal and post-renal. The pathophysiology in renal or intrinsic will depend on the specific cause and then a variety of causes including acute glomerulonephritis, interstitial nephritis, acute tubular necrosis and disease of the renal arteries. In chronic kidney disease (CKD), there is a progressive loss of nephrons irrespective of the primary site of the insult, cortical or medullary whether resulting from glomerular, tubular or interstitial.

Structural, hormonal and functional changes occur with ageing in the reproductive system. Changes occur in the structure of the prostate gland in the three different zones with ageing. Benign prostate hypertrophy (BPH) is a common part of ageing. Static and dynamic factors contribute to bladder neck obstruction in BPH, the former due to prostatic enlargement and the latter to the tension in the prostate smooth muscle. It is widely deemed that prostatic intraepithelial neoplasia (PIN) is the most likely forerunner of invasive prostatic cancer. However, not all high-grade PIN go into invasive disease but high-grade PIN, age- and prostatic-specific antigen (PSA) are deemed to indicate prediction of prostatic cancer. The sexual response in both male and female elderly is generally slow and of diminished intensity. Erectile dysfunction increases with age and is about 50 % in the over 70 years and older. Urinary incontinence is one of the biggest challenges facing the elderly population and with a high prevalence especially among women.


Age-related changes Glomerular disease Renovascular disease Acute kidney injury Chronic kidney disease Benign prostate hypertrophy Prostatic intraepithelial neoplasia Erectile dysfunction 


Anatomical and Physiological Changes with Ageing

  1. 1.
    Epstein M. Aging and the kidney. J Am Soc Nephrol. 1996;7(8):1106–22 (abstract).PubMedGoogle Scholar
  2. 2.
    Lameire N, Hoste E, Van Lo A, Dhondt A, Bernaert P, Vanholder R, et al. Pathophysiology, causes and prognosis of acute renal failure in the elderly. Ren Fail. 1996;8:333–46.CrossRefGoogle Scholar
  3. 3.
    Abdel-Kader K, Palevsky P. Acute kidney injury in the elderly. Clin Geriatr Med 2009;25(3):331–5.Google Scholar
  4. 4.
    Godin M, Moulin B, Etienne I, Fillastre JP. Renal aging in man. Presse Med. 1992;21(26):1246–8 (abstract).PubMedGoogle Scholar
  5. 5.
    Dunnill MS, Halley W. Some observations on the quantitative anatomy of the kidney. J Pathol. 1973;11:121.Google Scholar
  6. 6.
    Porush JG, Faubert PF. Renal disease in elderly patients. Rev Clin Gerontol. 1997;7(4):299–307 (abstract).CrossRefGoogle Scholar
  7. 7.
    Bolton WK, Sturgill BC. Spontaneous glomerular sclerosis in aging Sprague–Dawley rats. Am J Pathol. 1980;98:339–50.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Hollenberg NK, Adams DF, Solomons HS, Rashid A, Abrams HL, Merrill JP. Senescence in renal vasculature in normal man. Circ Res. 1974;34:309–76.PubMedCrossRefGoogle Scholar
  9. 9.
    Martin JE, Sheaff MT. Renal ageing. J Pathol. 2007;211(2):198–205 (abstract).PubMedCrossRefGoogle Scholar
  10. 10.
    Lubran MM. Renal function in the elderly. Ann Clin Lab Sci. 1995;25(2):122–33.PubMedGoogle Scholar
  11. 11.
    Lindeman BD, Tobin I, Shock NW. Longitudinal study in the rate of decline in renal function with age. J Am Geriatr Soc. 1985;33:278–85.PubMedCrossRefGoogle Scholar
  12. 12.
    Kleiston JT, Bode-Boger SM, Haller H, Fliser D. Functional changes in the ageing kidney: is there a role for asymmetric dimethylarginine? Nephrol Dial Transplant. 2003;18(7):1245–8.CrossRefGoogle Scholar
  13. 13.
    Gardiner SM, Kemp PA, Bennett T, Palmer RM, Macada S. Regional and cardiac haemodynamic effects of NG, NG,dimethyl-L-arginine and their reversibility by vasodilators in conscious rats. Br J Pharmacol. 1993;110:1457–62.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Darnmady EM, Offer J, Woodhouse MA. The parameters of the aging kidney. J Pathol. 1973;109:195–207.CrossRefGoogle Scholar
  15. 15.
    Spitzer A, Brandis M. Functional and morphological maturation of the superficial nephrons. J Clin Invest. 1974;53:279–87.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Mudler WJ, Hillen HF. Renal function and renal disease in the elderly: part 1. Eur J Intern Med. 2001;12:86–97.CrossRefGoogle Scholar
  17. 17.
    Inserra F, Romano LA, de Cavanagh EM EM, Ercole L, Ferder LF, Gomez RA. Renal interstitial sclerosis in aging: effects of enalapril and nifedipine. J Am Soc Nephrol. 1996;7:676–80.PubMedGoogle Scholar
  18. 18.
    Luckey AE, Parsa CJ. Fluid and electrolytes in the aged. Arch Surg. 2003;138:1055–60.PubMedCrossRefGoogle Scholar

Glomerular Disease in the Elderly

  1. 19.
    Abrass CK. Renal biopsy in the elderly. Am J Kidney Dis. 2000;35:544–6.PubMedCrossRefGoogle Scholar
  2. 20.
    Sabins SG, Antonoiych TT. A study of 500 cases of kidney diseases in the elderly. Geriatr Nephrol Urol. 1993;3(1):15–22.CrossRefGoogle Scholar
  3. 21.
    Davison AM. Renal disease in the elderly. Nephron. 1998;50:6–16 (abstract).CrossRefGoogle Scholar
  4. 22.
    Sanchez-Fructuoso A, Macia M, Blanco J, Barrientos A. Glomerular disease in the elderly: incidence and clinicopathologic findings: a 20 year retrospective study. Geriatr Nephrol Urol. 1993;3(2):65–70.CrossRefGoogle Scholar
  5. 23.
    Prakesh J, Singh AK, Saxena RK, Usha. Glomerular diseases in the elderly in India. Int J Urol Nephrol. 2000;353:283–8.Google Scholar

Renovascular Disease in the Elderly

  1. 24.
    American College of Cardiology/American Heart Association. ACC/AHA. Pocket Guidelines-Management of patients with peripheral arterial disease. American College of Cardiology Foundation and American Heart Association, Inc. March 2006.Google Scholar
  2. 25.
    Schmidt RT, Siman SS. Renovascular hypertension. eMedicine. 2008.Google Scholar
  3. 26.
    United States Renal Data System 1997. Annual data report. Am J Kidney Dis. 1997;30(Suppl 1):S1–213.Google Scholar
  4. 27.
    Textor SC, Wilcox CS. Renal artery stenosis: a common treatable cause for renal failure? Annu Rev Med. 2001;52:421–42 (abstract).PubMedCrossRefGoogle Scholar
  5. 28.
    Woolfson RG. Renal failure in atherosclerotic renovascular disease: pathogenesis, diagnosis and intervention. Postgrad Med J. 2001;77:68–74.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 29.
    Eardley KS, Lipkin GW. Atherosclerotic renal artery stenosis: is it worth diagnosing? J Hum Hypertens. 1999;13(4):217–20 (abstract).PubMedCrossRefGoogle Scholar
  7. 30.
    Bosmans JL, De Broe ME. Renovascular hypertension: diagnostic and therapeutic challenges. JBR-BTR. 2004;87(1):32–5 (abstract).PubMedGoogle Scholar
  8. 31.
    Olin JW, Melia M, Young JR, Graor RA, Risius B. Prevalence of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med. 1990;88:46N–51.PubMedCrossRefGoogle Scholar
  9. 32.
    Sawicki PT, Kaiser S, Heinemann L, Frenzel H, Berger M. Prevalence of renal artery stenosis in diabetes mellitus-an autopsy study. J Intern Med. 1991;229:489–92.PubMedCrossRefGoogle Scholar
  10. 33.
    Zierler RE, Bergelin RO, Polissar NL, Beach KW, Caps MT, Cantwell-Gab K, et al. Carotid and lower extremity arterial disease in patients with renal artery atherosclerosis. Arch Intern Med. 1998;158:761–7.PubMedCrossRefGoogle Scholar
  11. 34.
    Zoccali C, Mallamaci F, Finocchiaro P. Atherosclerotic renal artery stenosis: epidemiology, cardiovascular outcomes and clinical prediction rules. JASN. 2002;1:S179–83.CrossRefGoogle Scholar

Acute Kidney Injury (AKI)

  1. 35.
    Kellum JA. Acute kidney injury. Crit Care Med. 2008;36:S141–5.PubMedCrossRefGoogle Scholar
  2. 36.
    Peacock Jr PR, Sinert R. Renal failure, acute.
  3. 37.
    Kellum JA, Heste EA. Acute kidney injury: epidemiology and assessment. Scand J Clin Lab Invest. 2008;241(Suppl):6–11 (abstract).CrossRefGoogle Scholar
  4. 38.
    Chung KK, Stewart IJ, Gisler C, Simmons JW, Aden JK, Tolley MA, et al. The Acute Kidney Injury Network (AKIN) criteria applied in burns. J Burns Care Res. 2012;33(4):483–94.CrossRefGoogle Scholar
  5. 39.
    Lameire N, Van Hoste E, Loo A, Dondt A, Bernaert P, Vanholder R. Pathophysiology, causes and prognosis of acute renal failure in the elderly. Ren Fail. 1996;18:333–46.PubMedCrossRefGoogle Scholar
  6. 40.
    Andreucci VE, Fuiano G, Russo D, Andrecucci M. Vasomotor nephropathy. Nephrol Dial Transplant. 1998;13 Suppl 7:17–24.PubMedCrossRefGoogle Scholar
  7. 41.
    Anderson S. Fluid and electrolyte disorders in the elderly. In: Kokko JP, Tannen RL, editors. Fluid and electrolytes. Philadelphia: Saunders; 1996. p. 831–9.Google Scholar
  8. 42.
    Mandal AK, Baig M, Koutoubi Z. Management of acute renal failure in the elderly. Treatment options. Drugs Aging. 1998;9(4):219–50 (abstract).Google Scholar
  9. 43.
    Rose BD, Post TW. NSAIDS: acute kidney injury (acure renal failure). And nephrotic syndrome. Retrieved 18 May 2009.
  10. 44.
    Cheung CM, Ponnusamy A, Anderton JG. Management of acute renal failure in the elderly patient: a clinicians guide. Drug Aging. 2008;25(6):455–76 (abstract).CrossRefGoogle Scholar
  11. 45.
    Bidani A, Churchill PC. Acute renal failure. Dis Mon. 1989;35:57–132.PubMedCrossRefGoogle Scholar
  12. 46.
    Miura K, Goldstein RS, Morgan DG, Pasino DA, Hewitt WR, Hook JB, et al. Age-related differences in susceptibility to renal ischaemia in rats. Toxicol Appl Pharmacol. 1987;87:284–96.PubMedCrossRefGoogle Scholar
  13. 47.
    Halfer M, Schelling G. Acute kidney failure. Physiopathology-clinical diagnosis-therapy. Anaesthetist. 2000;49(4):349–52 (abstract).CrossRefGoogle Scholar
  14. 48.
    Serdar MA, Kurt I, Ozcelik E, Urhan M, Ilgan S, Yenicesu M. A practical approach to glomerular filtration rate measurements: creatinine clearance estimation using cimetidine. Ann Clin Lab Sci. 2001;31:265–73.PubMedGoogle Scholar
  15. 49.
    Urakami Y, Kimura N, Okuda M, Inui K. Creatinine transport by basolateral organic cation transporter hOCT2 in the human kidney. Pharm Res. 2004;21:976–81.PubMedCrossRefGoogle Scholar
  16. 50.
    Warnock DG. Towards a definition and classification of acute kidney injury. J Am Soc Nephrol. 2005;16:3149–50.PubMedCrossRefGoogle Scholar
  17. 51.
    Macias-Nunez JF, Lopez-Novoa JM, Mariinez-Maldonado M. Acute renal failure in the aged. Semin Nephrol. 1996;16(4):330–4.PubMedGoogle Scholar

Chronic Kidney Disease in the Elderly

  1. 52.
    Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition classification of chronic kidney disease: a positive statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67(6):2089–100.PubMedCrossRefGoogle Scholar
  2. 53.
    United States Renal Data System 1997. Annual Data Report. Am J Kidney Dis. 1997;30(Suppl. 1):S1–213.Google Scholar
  3. 54.
    Hostetter TH, Olson TL, Renuke HG, Venkatachalam MA, Brenner BH. Hyperfiltration in emanant nephrons: a potential adverse response to renal ablation. Am J Physiol. 1981;241:F85–93.PubMedGoogle Scholar
  4. 55.
    Remazzi G, Bratam T. Pathophysiology of progressive nephropathies. NEJM. 1998;339:1448–56.CrossRefGoogle Scholar
  5. 56.
    Wuhl E, Schaefer F. Managing kidney disease with blood pressure control: pathophysiology of CKD progression. Medscape. Retreived 2/07/2013.
  6. 57.
    Wang SN, Hirschberg R. Growth factors ultrafiltration in experimental diabetic nephropathy contributes to interstitial fibrosis. Am J Physiol Renal Physiol. 2000;218:F554–60.Google Scholar
  7. 58.
    Zoja C, Donadelli S, Colleoni M, Figiuzzis S, Bonazzola M, Morigi M, et al. Proximal tubular cell synthesis and secretion of endothelin-I on challenge with albumin and other proteins. Am J Kidney Dis. 1995;26:934–41.PubMedCrossRefGoogle Scholar
  8. 59.
    Lee LK, Meyer TW, Pollock AS, Lovett DH. Endothelial injury initiates glomerulosclerosis in the rat permanent kidney. J Clin Invest. 1995;96:959–60.Google Scholar
  9. 60.
    Takano T, Brady HR. The endothelium in glomerular inflammation. Curr Opin Nephrol Hypertens. 1995;4:277–86.PubMedCrossRefGoogle Scholar
  10. 61.
    Peterson JC, Adler S, Burkart JM, Greene T, Herbert LA, Hunsicker LG, et al. Blood pressure control, proteinuria and the progression of renal disease. The modification of diet in renal disease study. Ann Inter Med. 1995;123:754–62.CrossRefGoogle Scholar
  11. 62.
    Ruggenenti P, Echieppati A, Remuzzi G. Progression, remission, regression in chronic renal diseases. Lancet. 2001;357:1601–8.PubMedCrossRefGoogle Scholar
  12. 63.
    Lopez-Novoa JM, Rodriguez-Pena AB, Oritz A, Marinez-Salgado C, Hernandez FJ. Etiopathology of chronic tubular, glomerular and renovascular nephropathies: clinical implications. J Trans Med. 2011;9:13. doi: 10.1186/1479-5876-9-13.CrossRefGoogle Scholar
  13. 64.
    Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation and classification of renal osteodystrophy. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69:1945–53.PubMedCrossRefGoogle Scholar
  14. 65.
    National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation and stratification. Am J Kidney Dis. 2002;39(2):S1–266 [Medline].CrossRefGoogle Scholar

Ageing and the Reproductive System

  1. 66.
    Chahal HS, Drake WM. The endocrine system and ageing. J Pathol. 2007;211:173–80.PubMedCrossRefGoogle Scholar
  2. 67.
    Knight J, Nigam Y. The physiology of ageing 8-the reproductive system. Nurs Times. 2008;104(46):24–5.Google Scholar
  3. 68.
    Hermann M, Untergasser G, Rumpold H, Berger P. Aging of the male reproductive system. Exp Gerontol. 2000;35:1267–79 (abstract).PubMedCrossRefGoogle Scholar
  4. 69.
    Tsitoura P, Bulat T. The aging male reproductive system. Endocrinol Metab Clin N Am. 1995;24:295–315.Google Scholar
  5. 70.
    Gray A, Berton JA, McKinley J, Longcope C. An examination of research design effects on the association of testosterone and male ageing. Results of a meta analysis. J Clin Epidemiol. 1991;7:671–84.CrossRefGoogle Scholar
  6. 71.
    Bremner WJ, Vitiello MV, Prinz PN. Loss of circadian rhythmicity in blood testosterone levels in aging normal me. J Clin Endocrinol Metab. 1983;56:1278–81.PubMedCrossRefGoogle Scholar
  7. 72.
    Bagatell CJ, Bremner WJ. II. Changes in reproductive hormones during the aging process. J Clin Endocrinol Metab. 1998;83:34–6 (abstract).Google Scholar
  8. 73.
    Montague SE, Watson R, Herbert R. Physiology for nursing practice. 3rd ed. Oxford: Bailli Tindall; 2005.Google Scholar
  9. 74.
    Pellicer A, Simon C, Remohi J. Effects of aging on the female reproductive system. Hum Reprod. 1995;10 Suppl 2:77–83 (abstract).PubMedCrossRefGoogle Scholar
  10. 75.
    Brzyski RG, Knudtson J. Effects of aging on the female reproductive system. The Merck Manual Home edition. 2013. 13 Sep 2014.
  11. 76.
    Riggs BL, Melton LJI. Involutional osteoporosis. NEJM. 1986;314:1676–86.PubMedCrossRefGoogle Scholar
  12. 77.
    Masters WH, Johnson VE. Sex and aging process. J Am Geriatr Soc. 1981;29:385.PubMedCrossRefGoogle Scholar

Prostate Gland an Related Disorders

  1. 78.
    Weerakkody Y, Maingard J. Prostate. Accessed 26 Jan 2015.
  2. 79.
    Canadian Cancer Society. Anatomy and physiology of the prostate. http://www.cancerca/en/cancer-information/cancer-type/prostate/anatomy and physiology.?region+on. Retrieved on 26 Jan 2015.
  3. 80.
    Villiers GM, Verstraete K, De Neve WJ, Meerleer GO. Magnetic resonance imaging anatomy of the prostate and the periprostatic area: a guide for radiotherapists. Radiother Oncol. 2005;76(1):99–106.CrossRefGoogle Scholar
  4. 81.
    Sinnathamby C. Last’s anatomy 10. Churchill Livingstone. Elsevier; 2005.Google Scholar
  5. 82.
    Lepor H. Pathophysiology of benign prostatic hyperplasia in the aging male population. Rev Urol. 2005;7 Suppl 4:S3–12.Google Scholar
  6. 83.
    McNeal JE. The prostate gland. Morphology, pathobiology. Monogr Urol. 1983;4:5–13.Google Scholar
  7. 84.
    Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human prostatic hyperplasia with age. J Urol. 1984;132:474–9.PubMedGoogle Scholar
  8. 85.
    Levelliee RJ, Patel VR, Bird VG. Prostate hypertrophy, benign. eMedicine Update. 2006.Google Scholar
  9. 86.
    Lepor H. Pathogenesis, epidemiology and natural history of benign prostate hypertrophy. Rev Urol. 2004;6 Suppl 9:S3–10.Google Scholar
  10. 87.
    Walsh PC, Madder JD, Harrod M. Familial incomplete male pseudohermaphroditism type 2: decreased dihydrotestosterone formation in pseudovaginal perineoscrotal hypospadias. NEJM. 1974;291:944–9.PubMedCrossRefGoogle Scholar
  11. 88.
    Diamond DA. Sexual differentiation normal and abnormal. In: Walsk PC, Retik AB, Vaughan Jr ED, Wein AJ, editors. Campells urology. 8th ed. Philadelphia: WB Saunders Co; 2002. p. 2395–527.Google Scholar
  12. 89.
    Caine M. The present role of alpha-adrenergic blockers in the treatment of benign prostate hypertrophy. J Urol. 1986;136:1–6.PubMedGoogle Scholar
  13. 90.
    Editor’ summary of meeting presentation in Lepor H. Pathophysiology of benign prostatic hyperplasia in the aging male population. Rev Urol. 2005;7(Suppl. 4):S3–S12.Google Scholar
  14. 91.
    Krieger JN. Classification, epidemiology and implications of chronic prostatitis in North America, Europe and Asia. Minerva Urol Nefrol. 2004;56:99–107.PubMedGoogle Scholar
  15. 92.
    Ramakrishnan K, Salinas RC. Prostatitis acute and chronic. Prim Care Clin Office Pract. 2010;37(3):547–63.CrossRefGoogle Scholar
  16. 93.
    Maitre S. Prostatitis: prevalence classification and treatment. Virtual Mentor. 2006;8(11):748–51.PubMedCrossRefGoogle Scholar
  17. 94.
    Andriole GL. Prostatitis. The Merck Manual Professional Edition. Accessed 27 Jan 2015.
  18. 95.
    Anothaisintawee T, Attin J, Nickel JC, Thammaraisom S, Numthavaj P, McEvoy M, et al. Management of chronic prostatitis/chronic pelvic pain. JAMA. 2011;305(1):78–86.PubMedCrossRefGoogle Scholar
  19. 96.
    Faris G, Metz Y, Friedman B, Stein A. Prostatic abscess –diagnosis and treatment. Harefuah. 2008;147(7):594–6, 663 (abstract).PubMedGoogle Scholar
  20. 97.
    Venyo A. Prostatic abscess: case report and review of literature. WebmedCentral Urol. 2011;2(11):WMC002433.Google Scholar
  21. 98.
    Oliveira P, Andrade JA, Porto JE, Filho LE, Vinhaes AF. Diagnosis and treatment of prostatic abscess. Int Braz J Urol. 2003;29:30–4.PubMedCrossRefGoogle Scholar
  22. 99.
    Grndios EA, Caffaralti J, Farina L, Hoesman H. Prostatic abscess drainage clinical-sonography correlation. Urol Int. 1992;48:358–61.Google Scholar
  23. 100.
    Jameson RM. Prostatic abscess, carcinoma of the prostate. Br J Urol. 1968;40:288–92.PubMedCrossRefGoogle Scholar
  24. 101.
    Trauzzi SJ, Kay CJ, Kaufman DG, Lowe JC. Management of prostatic abscess in patients with immunodeficiency syndrome. Urology. 1994;93:629–33.CrossRefGoogle Scholar
  25. 102.
    Bansal P, Gupta A, Mongha R, Bera M, Ranjit K, Kunda AK. Minimally –invasive management of prostatic abscess. The role of transrectal ultrasound. Urol Ann. 2009;1:56–60.CrossRefGoogle Scholar

Prostatic Cancer

  1. 103.
    McNeal JE. The prostate gland. Morphology, pathobiology. Monogr Urol. 1983;4:5–13.Google Scholar
  2. 104.
    Gann PH. Risk factors for possible prostate cancer. Rev Urol. 2002;14 Suppl 5:S3–70.Google Scholar
  3. 105.
    Balistreri CR, Candore G, Lio D, Carruba G. Prostate cancer: from the pathophysiologic implications of some genetic risk factors to translation in personalized cancer treatments. Cancer Gene Ther. 2014;21:2–11. doi: 10.1038/cgt.2013.77.PubMedCrossRefGoogle Scholar
  4. 106.
    Dreicer R, Garcia J. Prostate cancer. Accessed 16 Mar 2015.
  5. 107.
    Bostwick DG. High grade prostatic intraepithelial neoplasia: the most likely precursor of prostate cancer. Cancer. 1995;75:1823–36.CrossRefGoogle Scholar
  6. 108.
    BMJ Best Practice. Prostate cancer. Retrieved 16 Mar 2015.
  7. 109.
    Velcheti V, Karnik S, Bardot SF, Prakash O. Pathogenesis of prostate cancer: lessons from basic research. Ochsner J. 2008;8(4):213–8.PubMedCentralPubMedGoogle Scholar
  8. 110.
    Stamey TA, Donaldson AN, Yemoto CE, McNeal JE, Soezen S, Gill H. Histological and clinical findings in 896 consecutive patients treated with radical retropubic prostatectomy: epidemiologic significance of annual changes. J Urol. 1998;160:2412–7.PubMedCrossRefGoogle Scholar

Sexuality and Sexual Dysfunction in with Aging

  1. 111.
    Kinsey A, Pomeroy W, Martin C. Sexual behaviour in human male. Philadelphia: WB Saunders; 1948.Google Scholar
  2. 112.
    Kinsey A, Pomeroy W, Martin C. Sexual behaviour in the human female. Philadelphia: WB Saunders; 1948.Google Scholar
  3. 113.
    Applegate WB. Sexuality in the elderly. In: Calkins E, Davis PJ, Ford AB, editors. The practice of geriatrics. Philadelphia: Pub WB Saunders Company; 1986.Google Scholar
  4. 114.
    Masters WH, Johnson VE. Sex and aging process. J Am Geriatr Soc. 1981;29:385–8.PubMedCrossRefGoogle Scholar
  5. 115.
    King R. Handbook of erectile dysfunction. Middle Cove: Intimate Solutions Pty; 2007.Google Scholar
  6. 116.
    Wagner G, de Tejafda IS. Update on male erectile dysfunction. BMJ. 1998;316:678–82.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 117.
    Andersson K, Wagner G. Physiology of penile erection. Physiol Rev. 1995;75:191–236 (abstract).PubMedGoogle Scholar
  8. 118.
    Lue TF, Zeineh SJ, Schmidt RA, Tanagho EA. Neuroanatomy of penile erection: its relevance to iatrogenic impotence. J Urol. 1984;131(2):273–80 (abstract).PubMedGoogle Scholar
  9. 119.
    Junemann KP, Persson-Junemann C, Lue TF, Tanagho EA, Aiken P. Neurophysiological aspects of penile erection: the role of the sympathetic nervous system. Br J Urol. 1989;64(1):84–92 (abstract).PubMedCrossRefGoogle Scholar
  10. 120.
    El-Sakka AI, Lue TF. Physiology of penile erection. Digital Urology Journal Articles website: Accessed 25 Aug 2008.
  11. 121.
    Junemann KP, Lue TF, Melchor H. The physiology of penile erection. Neurophysiology of penile erection. Urologe A. 1987;26:289–93 (abstract).PubMedGoogle Scholar
  12. 122.
    Ramopin O, Bernabe J, Giuliano F. Spinal control of penile erection. World J Urol. 1997;15(1):2–13 (abstract).CrossRefGoogle Scholar
  13. 123.
    Burnett AL. Role of nitric oxide in the physiology of erection. Biol Reprod. 1995;52:485–9 (abstract).PubMedCrossRefGoogle Scholar
  14. 124.
    Priviero FB, Leite R, Webb RC, Teixeira CE. Neurophysiological basis of penile erection. Acta Pharmacol Sin. 2007;28(6):751–5 (abstract).PubMedCrossRefGoogle Scholar
  15. 125.
    Giuliano F, Rampin O, Jardin A. Physiology of erection. La Rev de Med interne/fondee. 1997;18 Suppl 1:3s–9 (abstract).CrossRefGoogle Scholar
  16. 126.
    McKenna KE. Central control of penile extraction. Int J Impot Res. 1996;10 Suppl 1:S25–34 (abstract).Google Scholar
  17. 127.
    Andresson KE. Erectile physiological and pathophysiological pathways involved in erectile dysfunction. J Urol. 2003;170(2 Pt 2):S6–13 (abstract).CrossRefGoogle Scholar
  18. 128.
    Giuliano F, Clement P. Physiology of ejaculation: emphasis on serotonergic control. Eur Urol. 2013;48:408–17 (abstract).CrossRefGoogle Scholar
  19. 129.
    Haake P, Exton M, Haverkamp J, Kramer M, Loygraf N, Hartmann U, et al. Absence of orgasm-induced prolactin secretion in healthy multi-orgasmic male subject. Int J Impot Res. 2002;14:133–5.PubMedCrossRefGoogle Scholar
  20. 130.
    Gentili A, Mulligan T. Sexual dysfunction in older adults. Clin Geriatr Med. 1998;14:383–93.PubMedGoogle Scholar

Erectile Dysfunction in the Male Elderly

  1. 131.
    Nicholson A, Moreira Jr ED, Shirai M, Bin Mohd Thambi MI, Glasser DB. Epidemiology of erectile dysfunction in four countries: cross international study of the prevalence and correlates of erectile dysfunction. Urology. 2003;61:201–6.CrossRefGoogle Scholar
  2. 132.
    Parazzini F, Munchini FF, Bortolotti A, Calabro A, Chatenond L, Colli E, et al. Frequency and determinants of erectile dysfunction in Italy. Eur Urol. 2000;37:43–9.PubMedCrossRefGoogle Scholar
  3. 133.
    Weber MF, Smith DP, O’Connell DL, Patel M, de Souza PL, Sitas F, et al. Risk factors for erectile dysfunction in a cohort of 108477 Australian men. MJA. 2013;199(2):107–11.PubMedGoogle Scholar
  4. 134.
    Holden C, McLachlan RI, Pitts SM, CummingR Wittert G, Agius PA, et al. Men in Australia: Telephone Survey (MATEeS): a national survey of the reproductive health and concerns of middle- aged and older Australian men. Lancet. 2005;366:218–20.PubMedCrossRefGoogle Scholar
  5. 135.
    Lavelle P. Erectile dysfunction. ABC Health & Wellbeing. Retrieved 29 Aug 2008.
  6. 136.
    Chew KK, Earle CM. Stuckey BGA erectile dysfunction in general medical practice: prevalence and clinical correlations. Int Impot Res. 2000;12:41–5.CrossRefGoogle Scholar
  7. 137.
    O’Keefe M, Hunt DK. Assessment and treatment of impotence. N Med Clin N Am. 1995;79:415–34.Google Scholar
  8. 138.
    Buffum J. Pharmacosexology update: prescription drugs and sexual function. J Psychoactive Drugs. 1986;18:97–106.PubMedCrossRefGoogle Scholar
  9. 139.
    Guay AT. Erectile dysfunction-are you prepared to discuss? Postgrad Med. 1995;97:127–43.PubMedGoogle Scholar
  10. 140.
    Krane RJ, Goldstrin I, Saenz de Tejada I. Impotence. N Engl J Med. 1989;321:1648–9.PubMedCrossRefGoogle Scholar
  11. 141.
    Thase MG, Reynolds CF, Jennings JR. Nocturnal penile tumescence ids diminished in depression in men. Biol Psychiatry. 1988;24:33–46.PubMedCrossRefGoogle Scholar

Urinary Incontinence

  1. 142.
    Abrams P, Blaivas JG, Stanton SI, Andersen JT. The standardization of terminology of lower urinary tract function. The International Society Committee in Standardization Terminology. Scand J Urol. 1988;114(Suppl):5–19.Google Scholar
  2. 143.
    Mollander U, Sundh V, Stein G. Urinary incontinence and related symptoms in older men and women studied longitudinally between 70 and 97 years of age. A population study. Arch Gerontol Geriatr. 2002;35:237–44.CrossRefGoogle Scholar
  3. 144.
    Mayo Foundation for Medical Education and Research Geriatric Medicine. Urinary Incontinence (Internet) USA Mayo Clinic. 2010. Accessed 4 Aug 2013.
  4. 145.
    Sidik SM. The prevalence of urinary incontinence among elderly in rural community in Selangor. Malays J Med Sci. 2010;17(2):18–23.Google Scholar
  5. 146.
    Poi P. Giants of geriatrics II-incontinence. In: Srinivasas P, editor. Proceedings of First National Symposium on Gerontology 1995. Kuala Lumpur: University of Malaysia; 1995. p. 92–7.Google Scholar
  6. 147.
    Nakanishi N, Tatara K, Naramura H, Fujiwara H, Takashima Y, Fulkuda H. Urinary and faecal incontinence in a community residing older people in Japan. J Am Geriatr Soc. 1997;45(2):215–9 (abstract).PubMedCrossRefGoogle Scholar
  7. 148.
    Teunissen TA, van den Bosch WJ, van den Hoogen HJ, Largo-Jansson AL. Prevalence of urinary and faecal incontinence among community dwelling elderly patients in Nijmegen, The Netherlands. Ned Tidschr Geneeskd. 2006;150(44):2430–4 (abstract).Google Scholar
  8. 149.
    Yoshimura N. New insights into the neural mechanisms controlling the micturition reflex. Nihon Yakuurigaku Zasshi. 2003;121(5):290–8 (abstract).CrossRefGoogle Scholar
  9. 150.
    Yoshimura N, Kaiho Y, Miyazato M, Yunoki T, Tori C, Chancellor MB, et al. Therapeutic receptor targets for lower urinary tract dysfunction. Naunyn Schmiedebergs Arch Pharmcol. 2008;377(4–6):437–48 (abstract).CrossRefGoogle Scholar
  10. 151.
    Jaipaul N. Effects of aging on the urinary tract. The Merck Manual Home Edition. 2012. Accessed 12 Sep 2014.
  11. 152.
    Smith CM, Cotter VT. Age related changes in health. Hartford Institute for Geriatric Nursing. Accessed 12 Sep 2014.
  12. 153.
    Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical research and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55:780–91.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 154.
    Yu LC, Rohner TJ, Kaltreider L, Hu TW, Igou JF, Dennis PJ, et al. Profile of urinary incontinent elderly in long term care institutions. J Am Geriatr Soc. 1990;38:433–9.PubMedCrossRefGoogle Scholar
  14. 155.
    Vehkalalahti I, Kivela S-L. Urinary incontinence: and its correlates in very old age. Gerontology. 1985;31:391–5.CrossRefGoogle Scholar
  15. 156.
    DuBeau CE. Beyond the bladder “ management of urinary incontinence in older women. Clin Obstet Gynecol. 2007;50:720–34.PubMedCrossRefGoogle Scholar
  16. 157.
    Bocon-Gitod L. Urinary incontinence after radical prostactectomy. Eur Urol. 1997;6:112–6.Google Scholar
  17. 158.
    McConnell JD, Barry MS, Bruskewitz RC. Proatatic hyperplasia, diagnosis, treatment. Clinical Practice Guide-Line No. 8. Rockville: US Dept Health and Human Services Public Health Service Aging for Health Care Policy and Research.Google Scholar
  18. 159.
    Mathews CA, Whitehind WE, Townsend HK, Grodstein F. Risk factors for urinary and faecal incontinence on Nurses’ Health Study. Obstet Gynecol. 2013;122(3):539–48.CrossRefGoogle Scholar
  19. 160.
    Schulman C, Claesin H, Matthijs J. Urinary incontinence in Belgium: a population based survey. Eur Urol. 1997;32:315–20.PubMedGoogle Scholar
  20. 161.
    Milson I, Ekelund P, Molander U, Arvidsson L, Areskong B. The influence of age, parity, oral contraception, hysterectomy and the menopause in the prevalence of urinary infection in women. J Urol. 1997;149:1459–62.Google Scholar
  21. 162.
    Resnick NM, Yalla SV, Laurino E. The pathophysiology of urinary incontinence among institutionalized elderly persons. NEJM. 1989;320:1–7.PubMedCrossRefGoogle Scholar
  22. 163.
    Kuchel GA, DuBeau CE. Chapter 30. Urinary incontinence in the elderly. Geriaric Nephrology Curriculum. Am Soc Nephrol. 2009. p. 1–4.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 2
  • Gary Cheuk
    • 3
  1. 1.Sydney Medical School (Westmead)The University of SydneyNorth RocksAustralia
  2. 2.Norwest Specialist Medical GroupBella VistaAustralia
  3. 3.Blacktown-Mt Druitt HospitalBlacktownAustralia

Personalised recommendations