Male Incontinence

Male Incontinence Evaluation at Southland Urology

Urinary incontinence is the loss of bladder control, which can range from a minor leak to a complete inability to hold urine. While it can be an embarrassing topic, it is a very common condition that affects millions of people. It’s important to know that incontinence is a treatable medical condition, and you should not feel ashamed to talk to a healthcare professional about your symptoms to find the right treatment plan for you.

Understanding Male Incontinence

Male urinary incontinence is a condition where a man involuntarily leaks urine. While it can be an embarrassing and frustrating issue, it is a very common one, affecting millions of men. It is not a disease in itself but rather a symptom of another underlying condition, such as an enlarged prostate, nerve damage, or a weakened bladder sphincter. Understanding the specific type and cause of a man’s incontinence is the key to finding an effective treatment plan.

Types of Male Incontinence

There are several types of male incontinence, and a man may experience more than one. Stress incontinence is the leakage of urine when pressure is put on the bladder, such as during coughing, sneezing, laughing, or physical activity. It is often caused by a weakened urinary sphincter. Urge incontinence is characterized by a sudden, intense urge to urinate, followed by an involuntary loss of urine. This is often a symptom of an overactive bladder (OAB) caused by involuntary bladder muscle contractions. Overflow incontinence occurs when the bladder does not empty completely, and a constant dribble of urine results from the bladder being too full. This is often caused by a blockage, such as an enlarged prostate.

Causes and Risk Factors

The causes of male incontinence are varied. Enlarged prostate (BPH) is a very common cause, as it can block urine flow and lead to overflow incontinence. Prostate cancer treatments, such as a radical prostatectomy (removal of the prostate) or radiation, can also lead to incontinence by damaging the bladder sphincter or the nerves that control the bladder. Other causes include neurological disorders like Parkinson’s disease, multiple sclerosis, or a stroke, which can disrupt nerve signals to the bladder. Age and obesity are also significant risk factors.

Diagnosis

A thorough diagnosis is essential for determining the correct course of treatment. A urologist will conduct a physical exam and a review of the patient’s symptoms and medical history. Diagnostic tests may include a urinalysis to check for infection, a bladder diary to track urination patterns, and a physical exam to check for prostate enlargement. To get a more detailed picture, a urologist may perform urodynamic studies to measure bladder pressure and function or a cystoscopy to look inside the bladder for any blockages.

Non-Surgical Management

For most men with incontinence, non-surgical options are the first line of treatment. Lifestyle changes are often recommended, such as reducing caffeine and alcohol intake, managing fluid consumption, and losing weight. Bladder training can help a man learn to delay urination to improve bladder capacity. Pelvic floor exercises, also known as Kegel exercises, are crucial for strengthening the muscles that support the bladder and can be very effective for stress incontinence. Medications, such as those that relax the bladder muscle or shrink the prostate, can also be prescribed.

Surgical Management

When non-surgical treatments are not sufficient, surgical procedures may be recommended to treat the underlying cause of incontinence. For stress incontinence, a male urethral sling can be surgically placed to provide support and compression to the urethra. Another option is an artificial urinary sphincter, a small, inflatable cuff that is placed around the urethra and provides excellent control for severe stress incontinence. For overflow incontinence caused by BPH, procedures like TURP, UroLift, or Rezum can be performed to remove or shrink the prostate tissue, relieving the obstruction.