Don’t Ignore These Urinary Symptoms as You Age, Urologist Says

David Schnapp — AMP Urology (Associated Medical Professionals)
Ted Baker 6:03
Headshot of Dr. David Schnapp, a smiling man in a black suit jacket and yellow tie.
Dr. David Schnapp, associated with AMP Urology, was a guest on the FLX Morning Podcast.

Reduced urine flow, nighttime bathroom trips, and incontinence are easy to brush off as inevitable parts of aging — but a local urologist says some of those symptoms deserve a closer look before they become serious health problems.

Dr. David Schnapp of AMP Urology, part of Associated Medical Professionals (AMPofNY.com), joined the FLX Morning Podcast to walk listeners through the urinary symptoms that shouldn’t be ignored, and explain when a visit to a specialist is warranted.

On the question of reduced urinary flow, Schnapp said it’s not automatically cause for alarm — but context matters. When slower flow is paired with increased urgency, frequent urination during the day, or multiple trips to the bathroom at night, it can signal bladder outlet obstruction or other lower urinary tract issues that a urologist should evaluate.

Getting up once a night to urinate, Schnapp said, is generally less concerning than getting up three, four, or five times — but even a single nightly trip is worth mentioning to a doctor if it comes alongside other symptoms like urgency or slowing flow.

Incontinence, he said, is a more serious red flag. Beyond the obvious quality-of-life concerns, incontinence in older adults can sometimes be the only outward sign of a urinary tract infection — particularly in men, whose risk of UTIs rises significantly with age as prostate enlargement can lead to incomplete bladder emptying. That retained urine creates an environment where infections can take hold and spread.

Left untreated, Schnapp warned, a UTI can travel upward to the kidneys — a condition called pyelonephritis — causing severe flank pain, fever, chills, and potentially sepsis. Older patients face compounded risk because the immune system’s ability to fight infection weakens with age.

Schnapp noted that embarrassment, while a factor for some patients, isn’t what he most commonly sees keeping people from seeking care. Still, he encouraged anyone experiencing urinary changes to bring them up with their doctor rather than wait.

AMP Urology is part of Associated Medical Professionals, based in the region and reachable at AMPofNY.com.

Read Full Transcript

Paul Szmal: Our guest on FLX Morning is Dr. David Schnapp from AMP Urology Associated Medical Professionals, AMP of NY.com. It's good to have you here. Welcome back. Thanks, Ted. How are you? Doing well. We're going to talk about why it's important not to ignore what might seem like ordinary symptoms. As we age, things change a little bit, and whether through embarrassment or fear or whatever, we sometimes don't think it's anything that we should pay any attention to. So let's start with urinary symptoms. When we get older, one thing that a lot of us experience is reduced flow. Is that necessarily something to be concerned about?

David Schnapp: Well, in most cases, I would say no, but when reduced flow becomes worse and severe or when it's accompanied with other symptoms like urinary frequency, urgency, getting up a lot at night to go to the bathroom, that can be a sign of bladder outlet obstruction or some other lower urinary tract problems that should be evaluated by a urologist. Now a lot of this stuff we're talking is going to apply to me. I'm 64, getting up on 65 years old. One of the questions I get asked when I go in to the doctor is how many times a night do you get up? And in my case, I say one or fewer. Is that about right for somebody my age?

Paul Szmal: I would say there's nothing that's right. You know, these things tend to get worse as you get older. Certainly, it's always better to have a good night's sleep and not get up to urinate at all. But getting up once to urinate obviously isn't as bad as getting up two, three, four, five times to urinate. But still, if it is associated with some slowing of the urinary flow or increased urgency or increased frequency of urination that happens during the day as well, then it's something that should be evaluated.

David Schnapp: Another thing that many people run into as they age is some degree of incontinence, whether it be just a little bit of leaking to losing control. Well, sure. Incontinence is not a pleasant thing to suffer from. And certainly, nobody wants to get old and wind up having to wear diapers or pads. You know, so incontinence, I would say, is a more worrisome symptom than getting up once or so at night to urinate. If you have incontinence, it could be from a variety of factors. Certainly, infection can cause incontinence. And you may not have the typical symptoms of burning or pain or seeing blood in the urine that come with infection when it's seen in younger individuals. As you get older, incontinence might be the only symptom of an infection that you have. So certainly, if you have any type of urinary incontinence at any age, you should be evaluated.

Paul Szmal: Now, you mentioned one of the potential problems is a UTI, a urinary tract infection. Those are, I believe, more common in women, but certainly not uncommon in men. Is that correct?

David Schnapp: Well, uncommon in younger men, but more and more common as we age. As men get older, prostates get enlarged. You wind up with some level of bladder dysfunction, possibly as a result of that prostate enlargement. That may lead to incomplete bladder emptying, which you may not be completely aware of based on your symptoms alone. And that incomplete bladder emptying can lead to stasis of urine. And when you've got residual urine in the bladder, you're going to be more prone to developing an infection. So in patients who lose their normal levels of immunity as you get older, in patients who have incomplete bladder emptying due to bladder outlet obstruction as you get older, you're going to be more prone to getting a UTI. And a UTI, as you know, can be more serious as you get older, because our ability to combat infection is reduced as well as we age.

Paul Szmal: And I know one of the things that UTIs can lead to is kidney problems that can be pretty serious.

David Schnapp: Yeah, certainly. I mean, if you get what's called an ascending urinary tract infection, where you get a UTI that might begin as a result of bladder outlet obstruction or prostate enlargement, incomplete emptying, and so on, if that infection is not effectively treated quickly enough, and your normal ability to combat infection is reduced due to aging or other medical conditions you may have, then that infection can sort of climb its way up to one of the kidneys or both kidneys, and you could wind up with what's called a pyelonephritis, which is basically a UTI or urinary tract infection of the kidneys, which can make you very, very sick. It can lead to severe flank pain, fevers, shaking chills, essentially, in the worst case scenario, can lead to sepsis.

Paul Szmal: Do you find, in your experience, is it still embarrassment, the most common barrier to patients sharing this information?

David Schnapp: You know, I don't know. I think embarrassment is an issue for some people, but I don't find that most people, at least the people that we wind up seeing, delay coming in to see us because they were embarrassed to talk about their urinary problems. We'll have more with Dr. David Schnapp from AMP Urology coming up next month on FLX Morning.