Urinary Incontinence in Men
Bladder control problems range from urinating too frequently to actual urine leakage, or urinary incontinence. Although this condition affects millions of people, many men feel too embarrassed to discuss it with their doctor, allowing the problem to continue to interfere with their quality of life. Our urologists understand how difficult it can be to open up about urinary incontinence. Our experienced urologists can recommend many new treatments to cure or manage your bladder control condition.
There are several types of urinary incontinence in men:
- Urge incontinence, or overactive bladder (OAB): Overactive bladder, or OAB, is a group of symptoms rather than a specific disease. Yet, it is not a normal part of aging and can negatively affect a man’s social, personal, and work life in a number of ways.
- Stress incontinence – Exercising, coughing, sneezing, or other activities put pressure on a weakened bladder sphincter and cause leaks.
- Overflow incontinence – In this type of incontinence, which mostly affects men, you don’t feel the urge to urinate, your bladder doesn’t empty well, and small amounts of urine may leak continuously.
- Total incontinence – This is the continuous leakage of urine.
- Mixed incontinence – This is a combination of any of the above types of urinary incontinence.
Overactive Bladder (OAB) in Men
OAB is a group of symptoms and not a specific disease. It occurs when urine leaks when the bladder contracts when it shouldn’t. The hallmark symptom of OAB is an extreme “gotta go” feeling, or the sudden urge to urinate. This overwhelming urge is one of the main signs that you may be living with overactive bladder (OAB). Other symptoms of OAB include urine leakage, increased urination frequency, and waking up multiple times at night to urinate (nocturia). Treatments include physical therapy, lifestyle modifications, and medication.
Overflow Incontinence in Men
Men who cannot completely empty their bladder and experience unexpected urine leakage may have overflow incontinence. This type of urinary incontinence is caused by the inability to detect a full bladder, which then leads to leakage as the bladder has reached its full capacity. In addition to leakage, urine left in the bladder can lead to urinary tract infections due to the growth of bacteria as well as bladder stones. Overflow incontinence is more common in men than women, with the leading cause being an enlarged prostate or BPH. Treatments include medications, self-catheterization, or surgery.
Stress Urinary Incontinence (SUI) After a Radical Prostatectomy
Stress incontinence is a common side effect of prostate cancer surgery, specifically radical prostatectomy (complete removal of the prostate). In fact, urinary incontinence is a problem to some degree for most men following prostate surgery and radical prostatectomy. The prostate gland aids the urethral sphincter in bladder control by providing support for the bladder neck. When the prostate is removed, so is the support, which sometimes causes urine to leak when pressure is put onto the bladder. Added pressure can be in the form of exercise, lifting and even sneezing, coughing, laughing, and sex.
First-line therapies include physical therapy, pelvic rehab, fluid/diet management, and lifestyle modifications. If these treatments are unsuccessful, surgery may be the next step. Surgical treatments include male urethral slings, artificial urinary sphincter, or urethral bulking.
Causes of Urinary Incontinence in Men
Certain diseases and conditions that damage nerves can lead to urinary incontinence, such as diabetes. Other suffer from neurological conditions such as stroke, Parkinson’s disease, and multiple sclerosis, all of which affect the brain and nervous system. Spinal cord injuries can interrupt the nerve signals required to control the bladder, as well.
Men who have prostate conditions often experience some type of bladder control issues at some point in their lives. These conditions include:
- BPH/enlarged prostate – BPH affects the flow of the urine from the bladder through the urethra and can cause changes in bladder function. BPH causes a number of urinary symptoms including weak urine stream, urinary urgency and leakage, frequent urination, nocturia, as well as overactive bladder.
- Radical prostatectomy – Complete surgical removal of the prostate gland (radical prostatectomy) is a common treatment option for men with prostate cancer. The procedure can cause nerve and/or muscle damage in the area surrounding the prostate, leading to urinary incontinence.
- External beam radiation therapy – This prostate cancer treatment may result in temporary changes in frequency and urgency of urination or can lead to more permanent bladder problems.