The incidence of lower urinary tract symptoms increases with age. People with bladder disorders who are older than 60 years are more likely to comply and persist with treatment regimens, such as antimuscarinic medications for overactive bladder. Suggestions for these differences include lifestyle factors, greater compliance with medication prescription, or pharmacological and physiological changes to the receptors within the bladder tissue itself. This scoping review focused on the latter and sought to identify if there is recent evidence to support a prominent role for the internal lining of the urinary bladder, the bladder mucosa (urothelium with lamina propria), in age-related alterations. Although there continues to be substantial urological research in humans, animal models remain highly important for the assessment of physiological and pharmacological changes in the bladder. Recent work in this field brings insights into the overall understanding of bladder function and dysfunction. The PUBMED database was searched for studies published between 2018 and 2022. From the 25 articles identified, 10 were eligible for inclusion in the evaluation, and a risk of bias assessment was performed. Studies reported a variety of age-related alterations in the bladder mucosa. The most pronounced changes appear to be an inhibition of the mucosal barrier function and signalling pathways with ageing. Ageing also appeared to inhibit receptor systems associated with contraction inhibition, potentially leading to enhanced contractions. The overall evidence suggests that the increased prevalence of bladder contractile disorders seen in ageing may be due, in some part, to physiological alterations occurring within the bladder tissue itself.
Due to the COVID-19 pandemic, many group education sessions provided by healthcare services during 2020 were transitioned to telehealth. Research evaluating the delivery of group continence education via telehealth is limited. To investigate the feasibility of telehealth continence education, we conducted a retrospective audit of telehealth classes from July to December 2020 and in-person continence education classes from July to December 2018. We compared client attendance to classes, demographic data including age and distance lived from the clinic, feedback survey responses, and time spent by staff organising and conducting the classes. Quantitative data were analysed using descriptive statistics. Qualitative survey responses were analysed to identify key feedback. The non-attendance rate for the telehealth classes was 32% (n=13) compared to 35% (n=26) for the in-person classes. Feedback for the telehealth classes was positive, with 73% of survey respondents agreeing or strongly agreeing that it was easy to join the session. All respondents agreed or strongly agreed that the telehealth classes were interesting compared to 94% of respondents for the in-person classes. Lack of access to, or familiarity with, technology were limiting factors for telehealth class attendance. Telehealth therefore appears to be a feasible modality for the delivery of continence education classes, with comparable attendance rates to in-person classes. However, access to technology may be a barrier to attendance for some clients and telehealth classes may be more time consuming for clinicians.