Stress Urinary Incontinence in Men

Have You Ever Sneezed, Coughed, or Laughed Only to Leak Urine?

If so, you’re not alone. You may be experiencing stress urinary incontinence, the involuntary loss or leakage of urine that occurs during physical activity such as exercise, laughing, coughing and sneezing. The “stress” is added pressure on your bladder. Oftentimes, weakened pelvic muscles allow urine to leak when a cough, sneeze or other action puts pressure on the bladder.

Diagnosing Stress Incontinence

Your doctor will begin by performing a physical exam and taking a medical history in order to diagnose your bladder control issue. He or she may also order additional diagnostics tests including:

• Urinalysis
• Blood work
• A bladder diary – your physician may ask you to keep a record of what you drink, your urine output, when leakage occurs and what you were doing (coughing, laughing, exercising, etc.) when urine leakage occurred.

Specialized tests may also be performed to get a clear idea of the cause of your stress incontinence including:

• Pelvic ultrasound: This test checks for structural abnormalities of the lower urinary tract and can assess for bladder abnormalities.
• Post-void residual test (PVR): Determines how well you empty your bladder by measuring residual urine after voiding. Measuring residual urine may aid your doctor in determining if there is a blockage or nerve or muscle problem.
• Cystoscopy: A small camera called a cystoscope is inserted into the urethra to inspect the urethra, prostate, and bladder for any visual abnormalities. This procedure can be performed in your doctor’s office or ambulatory surgery center under topical local anesthesia.
• Urinary stress test: Looks for leaking urine when you cough, laugh or put other types of pressure on your bladder.
• Cystogram: A special X-ray of your bladder taken while filling and evacuating.
• Urodynamic tests: Diagnostic tests that evaluate the function of the bladder and urethra and include Uroflow, cystometrogram, EMG, pressure flow study, or video-urodynamics.
• Urinalysis and urine culture, which checks urine for the presence of infection or abnormalities.

Stress Incontinence Following 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.

According to the National Association for Continence, “Studies have indicated that as many as 90% of men report leakage in the first few weeks following surgery after removal of the catheter.”