Gender differences in bladder control: from babies to elderly

Abstract

In both sexes, there are anatomical and behavioral differences in dealing with bladder control, as well as voiding and incontinence. Despite intensive research within the last decades, the differences in physiology and pathophysiology as well as gender differences of bladder control and continence are still poorly understood and further research is highly needed. In babies, gender difference seems to be most likely caused by a difference in maturity rate of the bladder. After gaining bladder control, behavior starts to be influenced by socialization. During preschool and school, children experience a negative perception of school toilets. Especially girls crouch over the toilet seat and train to empty the bladder without relaxation of the pelvic floor. This posture may lead to bladder dysfunction. Often adult women continue this bad habit and bladder dysfunction may consolidate. From the fourth decade in both sexes lower urinary tract symptoms start to develop. However, men and women handle the problem variedly showing gender differences in coping strategies with better coping mechanisms in women. In general, gender difference in help seeking and receiving treatment increases with younger age. In elderly, urinary incontinence is only associated with a higher mortality in men, and elderly men seek more often professional help. Aim of the review is to provide an insight into gender differences of bladder control and bladder dysfunction.

Re: Long-Term Followup of Children with Nocturnal Enuresis: Increased Frequency of Nocturia in Adulthood

“…In a study by Petrangeli et al, where young women with LUTS in childhood were reevaluated in adulthood, the prevalence of nocturia was 37% in those with a history of NE (19 patients) and 46% in those with a history of daytime LUTS, findings that are in line with our results based on patients with NE with or without daytime LUTS. 7,8 This finding is in line with the clinical observation that for 2 or more nocturnal voids the prevalence was 9.2% in girls and 2.4% in boys. 7,8 This finding is in line with the clinical observation that for 2 or more nocturnal voids the prevalence was 9.2% in girls and 2.4% in boys.…”

Gender Differences in Coping Strategies for Troublesome Lower Urinary Tract Symptoms Prior to Seeking Treatment

“…They also found that lower urinary tract symptoms in both sexes start to develop from the fourth decades. "Men and women handle the problem variedly showing gender differences in coping strategies with better coping mechanisms in women" [13]. In our study, our patients showed diversity in symptoms distribution.…”

“…Our results are consistent with Bauer and Huebner, who found women to be more experienced with coping strategies in handling their LUTS and using pads to prevent urine leakage. Men are not used to buying and wearing pads [13].…”

“…In contrast, girls at this age are socialized to hide themselves when they empty their bladder. Finally, bladder control behaviors between boys and girls are completely different [13]. The differences in voiding behaviors between genders are consolidated in different stages, from preschool, school to grown-ups.…”

Gender in urology

“…Seitz and Fajkovic [11] identify gender-specific aspects in the prevalence, treatment and aftercare in urolithiasis patients with special attention to gender aspects associated with a history of kidney stones. Bauer and Hübner [12] provide a deeper insight into gender differences of bladder control and dysfunction. In the article on bladder outlet obstruction in men, Klatte et al [13] identify clinical predictors with first episode of spontaneous acute urinary retention in order to facilitate patient selection for early deobstructive prostate surgery.…”