Alleviating constipation in the elderly improves lower urinary tract symptoms

Background: Constipation and lower urinary tract symptoms (LUTS) very frequ ently occur in the elderly, and several reports have suggested that dysfunc tion in either one of these systems may affect the other. Most studies corr elating rectal and bladder dysfunction, however, have been carried out in c hildren or young women. Objective: To examine the effect of alleviating con stipation on LUTS in the elderly. Methods: Fifty-two patients aged 65-89 (m ean 72 +/- 13) years with chronic constipation and LUIS participated in thi s prospective cohort study. Before treatment of constipation was initiated and on their monthly visits, patients completed a questionnaire regarding t heir constipation pattern, urinary symptoms, sexual function and mood, and underwent urinary sis. Urinary tract anatomy and residual urine were evalua ted by abdominal ultrasound at the commencement and completion of the study . Patients were followed up for 4 months. Results: Treatment of constipatio n increased the number of weekly defecations from 1.5 +/- 0.9 to 4.7 +/- 1. 2 (p < 0.001). Patients spent less time on the toilet (25 <plus/minus> 2.1 versus 63 +/- 1.9 min, p < 0.0001). Fewer patients reported urgency (16 ver sus 34, p < 0.001), frequency (25 versus 47, p < 0.001) and burning sensati on during urination (6 versus 17, p < 0.05). There was improvement in the s coring of urgency, frequency and burning sensation (from a baseline of 52 t o 126, 131 and 95, respectively, p < 0.001). Urinary stream disturbances im proved in 32 of the 52 patients (p < 0.001). Residual urine volume decrease d from 85 +/- 39.5 to 30 +/- 22.56 mi (p < 0.001). There was also a signifi cant decrease in the number of patients with bacteriurial events (5 versus 17, p < 0.001), and an improvement in sexual activity and mood (p < 0.05). Conclusions: Our data demonstrated that medical relief of constipation sign ificantly improves LUTS in the elderly which, in turn, improves the patient 's mood, sexual activity and quality of life. Copyright <(c)> 2001 S. Karge r AG, Basel.