[The aging bladder. anatomy and physiology]

Micturition disorders in elderly people result from the interaction between several different factors such as medication, mobility, metabolism and physical as well as psychological health. Senile incontinence may occur as a single form but is often a mixture of various forms. With increasing knowledge on the pathophysiology of incontinence, prevention and therapy may become more efficient. Age-dependent structural alterations to the urinary bladder are predominantly due to functional disturbances. Neurophysiological studies have led to modified recommendations for micturition behaviour other than double micturition in cases of residual urine or bladder over-expansion in the elderly. The brain, the main point of control of continence and micturition and a postmitotic organ, is very vulnerable to age-dependent disturbances. Research on cerebral organisation and control of continence, in addition to that on receptor-mediated and molecular-biological regulation processes, will have consequences for the health system and the action taken by the medical practitioner.