Urinary Incontinence in Men

General Steward Health Care

Urinary Incontinence in Men

Urinary incontinence (UI) is an accidental leaking of urine. It’s not a disease. It’s a symptom of a problem with a man’s urinary tract. Unfortunately, men don’t usually discuss this with their doctor. Even though this is not an uncommon problem, it is estimated that 3.4 million men in the United States currently experience UI, making life difficult both physically and emotionally. While often related to prostate problems, urinary incontinence has a variety of causes. It can also be brought on by medical conditions such as diabetes and Parkinson’s Disease and by pelvic surgical procedures including prostatectomy. However, like many conditions that were once thought to be an inevitable fact of aging, urinary incontinence in men is often due to underlying conditions that are treatable. Urologists are experts in the evaluation and treatment of UI with an array of evolving and cutting-edge techniques.

How It Happens

Urine is made by the kidneys and stored in a sac made of muscle, called the urinary bladder. A tube called the urethra leads from the bladder through the prostate and penis to the outside of the body. Around the tube is a ring of muscles called the urinary sphincter. As the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.

When you have to urinate the nerve signals tell the muscles in the walls of the bladder to squeeze. This forces urine out of the bladder and into the urethra. At the same time the bladder squeezes the urethra relaxes. This allows urine to pass through the urethra and out of the body.

Incontinence can happen for a variety of reasons:

  • If your bladder squeezes at the wrong time or it squeezes too hard urine may leak out.
  • If the muscles around the urethra are damaged or weak, urine can leak out even if you don’t have a problem with your bladder squeezing at the wrong time.
  • If your bladder doesn’t empty when it should, you are left with too much urine in the bladder.
  • If the bladder gets too full, urine will leak out when you don’t want it to.
  • If something is blocking the urethra, urine can build up in the bladder. This can cause leaking.

Incontinence is often related to prostate problems or treatments. Drinking alcohol can make urinary incontinence worse. Taking prescription over-the-counter drugs such as diuretics, antidepressants, sedatives, opioids, or non-prescription cold and diet medicines can also affect your symptoms.

Urinary incontinence happens more often in older men than younger men. However, it’s not just a normal part of aging.

What Are the Types and Symptoms of Urinary Incontinence?

Urinary incontinence can be short-term or long-lasting (chronic). Short-term incontinence is often caused by health problems or treatments. Here are the different types of chronic urinary incontinence.

  • Stress incontinence means that you leak urine when you stress, cough, laugh, lift something, change position, or do something that puts stress or strain on your bladder.
  • Urge incontinence is an urge to urinate that is so strong that you can’t make it to the toilet in time. It also happens when your bladder squeezes when it shouldn’t. This can happen even when you have only a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence but not everyone with an overactive bladder leaks urine.
  • Overflow incontinence means that you have the urge to urinate, but you can release only a small amount. Since your bladder doesn’t empty as it should, it then leaks urine later.
  • Total incontinence means that you’re always leaking urine. It happens when the sphincter muscle no longer works.
  • Functional incontinence means that you can’t make it to the bathroom in time to urinate. This is usually because something got in the way, or you were not able to walk there on your own.

What are some of the causes of urinary incontinence in men?

  1. Prostate problems. Prostate problems especially as men age can result in problems with urinary control. If the prostate is enlarged, it may affect the flow of urinary and cause a weak stream, frequent urination and leaking. When the prostate is removed for cancer treatment, it is not uncommon to have stress incontinence, whish is when physical movement such as coughing or sneezing causes leakage.
  2. Conditions that cause nerve damage. Because muscles and nerves must work together to control the bladder, any condition that damages the nerves can create urinary problems. Conditions such as Parkinson’s Disease, stroke, diabetes, multiple sclerosis, herniated discs, spinal cord injuries, and dementia.
  3. What and how much you drink. Certain types of beverages can stress the urinary system. Limiting the amount of alcohol and caffeine, both of which have a diuretic effect, can help bladder control issues. Although staying hydrated is important, it is vital not to overdo it with fluid intakes as this can exacerbate bladder control issues.
  4. Weight status. Being overweight can exacerbate urinary incontinence.

How is this treated?

Treatments depend on the type of incontinence you have and how it affects your life. Your treatment may include medicines, simple exercises, or both. A few men need surgery, but most don’t.

Below are many things to do at home. However, it is recommended that you talk to your healthcare provider and have them help you. Often a consult with a urologist would be recommended to evaluate in each individual case. With expert medical assistance, these home remedies can be adopted in addition to receiving any of the necessary treatments.

  • Watch your diet. Certain foods and drinks can be triggers for bladder problems in men as well as women. They include notably alcohol and caffeine as well as fizzy drinks, spicy foods, tomato products, chocolate, and citrus juices. Cut back on caffeine and limit your alcohol to no more than one drink a day.
  • Lose weight if you’re overweight. Excess fat, especially around the belly area, puts extra pressure on the pelvic muscles and bladder. Physical activity is a great way to lose weight and alleviate pressure on the bladder and is also good for general health.
  • Eat foods high in fiber to help avoid constipation.
  • Don’t smoke. If you need help quitting, talk to your doctor about stop smoking programs and medicines.
  • Try simple pelvic floor exercises like kegel. Kegel exercises strengthen the pelvic muscles – those that help control urine leakage. A urologist can help guide you in these exercises. Y
  • Practice bladder control. This entails urinating on schedule rather than doing it at every urge. Retraining the bladder can cut down on the frequency of the urge to go. Wear clothes that you can remove easily. Make your path to the bathroom as clean and quick as you can.
  • When you urinate practice double voiding. That means going as much as you can, relaxing for a moment and then going again.
  • Use a diary to keep track of your symptoms and any leaking of urine. This can help you and your doctor find the best treatment for you.

What happens if urinary incontinence goes untreated?

It is widely acknowledged that urinary incontinence remains greatly untreated. Men are much less likely to bring up the topic with their doctors as women. In fact, one study revealed that despite the wide variety of remedies for UI only one in five symptomatic men sought treatment. What’s more, the mental and emotional impact of urinary incontinence can be life altering. Embarrassment, anxiety, and depression are significant part of the diminishing quality of life caused by this condition.

Therefore, whatever you do, don’t ignore it. If you have symptoms of urinary incontinence don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured. Steward Medical Group and Sebastian River Medical Center have a world class urologist in your community.  Amr Fergany, MD is known world-wide for his advance’s treatments, surgical and non-surgical, for all urological conditions including surgical treatments for cancer.  To schedule your appointment, call (772) 918-4327.