As we age, our bodies go through many changes. One common change that many older adults experience is the frequent need to urinate. This can happen for a variety of reasons, but one of the most common is an increase in bladder size.
What causes bladders to get bigger with age?
There are a few key factors that contribute to bladder growth and increased urinary frequency in older adults:
- Loss of muscle tone – The bladder is a muscular organ. As we age, the muscles can weaken and lose tone, causing the bladder to not fully empty and expand over time.
- Hormonal changes – Decreases in estrogen in women and testosterone in men can cause changes to bladder and urethral tissues, leading to reduced muscle tone.
- Enlarged prostate – In men, prostate growth compresses the urethra, partially blocking urine flow out of the bladder and causing it to expand.
- Detrusor overactivity – The detrusor muscle in the bladder can become overactive with age, causing a strong urge to urinate frequently.
- Nerve damage – Conditions like diabetes, strokes, and nutritional deficiencies can damage bladder nerves and cause the bladder to expand.
As the bladder expands with age, its capacity to hold urine increases. Older adults may find themselves able to hold much more urine and go longer between bathroom breaks. However, the bladder may not fully empty each time which increases the risk of urinary tract infections.
How much can bladder size increase?
There are no precise statistics on how much bladder size increases with age, as the degree of growth depends on many individual factors. However, some general trends show that:
- Bladder capacity typically increases 1-2 ounces per decade of life.
- Bladders can grow from holding 1.5-2 cups in young adults to 3 or more cups in older adults.
- Men over age 70 may see their bladder size increase by 50% or more.
For example, a healthy 20-year-old may urinate 5-7 times a day and be able to hold 10-12 ounces (about 1.5 cups) of urine. A healthy 80-year-old may only need to urinate 3-4 times daily but be able to hold up to 25-30 ounces (3 cups) of urine.
Typical bladder sizes by age
| Age | Average Bladder Capacity |
|---|---|
| 20s | 10-12 oz (1.5 cups) |
| 30s | 12-14 oz (1.75 cups) |
| 40s | 14-16 oz (2 cups) |
| 50s | 16-20 oz (2.5 cups) |
| 60s | 20-24 oz (3 cups) |
| 70s | 24-28 oz (3.5 cups) |
| 80s+ | 25-30 oz (Up to 3.5 cups) |
Keep in mind these are estimates and individual capacity can vary greatly. Bladder size and urinary frequency changes should always be discussed with a doctor.
Risks associated with an enlarging bladder
An increase in bladder size may seem harmless at first. However, there are some risks to be aware of:
- Incomplete emptying – With a larger bladder, you may not empty it fully each time you urinate. Leftover urine allows bacteria to grow, raising UTI risk.
- Bladder distension – Chronic over-stretching of the bladder muscle can weaken its elasticity over time.
- Kidney damage – Pressure from an overfull bladder can back up into the kidneys, causing damage over time.
- Incontinence – Storage issues from a large bladder and frequent urges to urinate can lead to leakage.
- Bladder stones – Stagnant urine can allow minerals to crystallize into bladder stones.
That’s why it’s important to see a doctor if you notice a reduced urinary frequency or change in voiding patterns as you age. Some treatments and lifestyle changes can help keep your bladder healthy.
Treatments for an aging, expanding bladder
If your bladder is getting bigger with age, your doctor may recommend:
- Medications – Drugs that relax the bladder muscle, block nerve signals, or moderate hormones may improve tone and storage capacity.
- Bladder training – Similar to pelvic floor physical therapy, you learn techniques to retrain bladder muscles.
- Surgery – In severe cases, surgery to remove obstructions or increase urethral sphincter tone may help.
- Catheterization – For people who have trouble fully emptying their bladder, occasional catheterization may drain leftover urine.
Making some lifestyle adjustments can also help maintain bladder health:
- Urinate regularly and do not try to “hold it” for too long.
- Manage fluid intake to keep urine diluted but not overfill the bladder.
- Perform Kegel exercises to strengthen pelvic muscles.
- Maintain a healthy weight to reduce pressure on the bladder.
- Consider caffeine and alcohol reduction to minimize bladder irritation.
When to see a doctor
Consult your physician if you experience any of the following:
- Needing to urinate less than every 3-4 hours during the day.
- Waking up multiple times at night to urinate.
- Difficulty fully emptying your bladder.
- Painful urination, blood in the urine, or foul smelling urine.
- Sudden urges to urinate that cause incontinence.
- Weak urine stream or straining to urinate.
- Frequent bladder infections.
Your doctor can evaluate your symptoms, assess your bladder health, and recommend any necessary testing or treatment. Early intervention for bladder changes may help prevent complications.
Conclusion
It is common for the bladder to get bigger with age. Bladder capacity tends to increase while urinary frequency decreases in older adults. This is often caused by loss of muscle tone, hormone changes, and conditions like enlarged prostate in men. However, chronically overstretching the bladder can lead to risks like incontinence, retention, and kidney damage. That’s why it’s important to see your doctor if you notice any changes in urination patterns as you get older. With proper treatment and healthy bladder habits, you can keep this important organ functioning properly for years to come.