Senile Urinary Abnormalities 1997.12.22

Senile Urinary Abnormalities 1997.12.22

There are two main causes of senile urinary abnormalities: prostate enlargement and urinary incontinence.

1. Prostate Enlargement

Approximately 30% of men over 60 suffer from prostate enlargement. To date, digital rectal examination remains the most common method for diagnosing prostate enlargement, allowing determination of prostate size and presence of nodules on the surface, thus distinguishing it from prostate cancer. ① Stage One: frequent nighttime urination and discomfort in the perineal area; ② Residual urine appears, amounting to 30–50 mL; ③ Residual urine increases, bladder expands, urinary retention occurs, and post-renal uremia develops. For the first two stages, surgery is generally not required; surgery is indicated for the third stage. Japanese physician Ishibashi Akira advocates using Guifu Bawei Wan, Jisheng Shenqi Wan, and Ling Gui Shu Gan Tang for treating prostate enlargement. If there is fixed pain, it indicates blood stasis, and Dahuang Mudan Tang or Taohu Chengqi Tang can be used; if physical strength is weak, Guizhi Fuling Wan or Danggui Si Nisi Jia Wu Zhu Yu, Shengjiang can be given.

2. Urinary Incontinence

Thirty percent of women over 60 experience urinary incontinence. ① Stress Urinary Incontinence: often caused by relaxation of the urethral sphincter in multiparous women. Buzhong Yiqi Tang, Lianzi Qingxin Yin, and Wuling San can be used; ② Urgent Urinary Incontinence: bladder reflexive contraction, possibly caused by neurological, central, or psychological factors, characterized by intense urge to urinate and frequent urination, and Longdan Xie Gan Tang or Shao Yao Gancao Tang can be administered; ③ Reflex Urinary Incontinence: urine automatically leaks out, caused by residual urine in the bladder, and Bawei Wan or Jisheng Shenqi Wan can be used.