Male Incontinence

What is male incontinence?

If a man suffers from accidental or involuntary loss of control of the bladder, it is called urinary incontinence. While men tend to experience incontinence less often than women, it is not uncommon to experience at least some form of incontinence during their lifetime, especially as men age.  Incontinence is treatable, and often curable at all ages. 

What are the causes of male incontinence?

For the urinary system to function in men off all ages, the muscles and nerves in the body must all work together to hold urine in the body and then release it at the right time, and upon demand.  Any condition that has an affect on nerve or muscle performance can cause male incontinence. For example, overactive bladder, enlarged prostate, certain kinds of cancer, and nerve damage can all be causes of male incontinence.

How is male incontinence diagnosed?

The first step toward correctly diagnosing urinary incontinence is speaking with your physician about your medical history to discuss previous ailments or health issues.  Together, you and your physician can determine if any of your previous conditions could have had an impact on your urinary system.

Your physician may as you to keep a journal or records of your trips to the bathroom and on leakages, as the pattern and nature of leakage will help determine the type of incontinence you may be experiencing .

The next most common step is a physical examination, which may include a digital rectal exam, palpation of areas around the urinary tract, reflex tests, and the like, to gather more information about possible prostate enlargement or nerve damage.

An ultrasound or transracial ultrasound may be conducted, which is a harmless way for your physician to gather images of your prostate, kidney, bladder, or other designated area. 

Urine and blood samples may also be collected and analyzed to look for evidence of an infection, kidney stone, or metabolic imbalances. A urodynamic study may be conducted, in focuses on the bladder’s ability to store urine and empty steadily and completely. 

Not all of these tests are utilized in every patient. Testing stops as soon as the origin of the incontinence is reliably determined.

What are the symptoms of male incontinence?

Chronic incontinence is categorized according to the circumstances in which urine is lost.  Urge incontinence is the involuntary loss of urine following an overwhelming urge to urinate that can’t be stopped.  Stress incontinence is the involuntary loss of urine during actions such as sneezing, coughing, and lifting items, which put pressure on the abdomen and bladder.
Overflow incontinence is the constant loss of urine, in small, frequent amounts. 

How is male incontinence treated?

Treatment options differ depending on the kind of incontinence one is experiencing, as well as due to the primary cause of the incontinence.  Acute urinary incontinence associated with infections, kidney stones or medication side effects often resolves when the primary problem is successfully treated.

The nature and mix of therapeutic measures are tailored to each individual patient.

Percutaneous Tibial Nerve Stimulation (PTNS) 

PTNS the least invasive form of neuromodulation used to treat overactive bladder (OAB) and the associated symptoms of urinary urgency, urinary frequency and urge incontinence that works by indirectly providing electrical stimulation to the nerves responsible for bladder and pelvic floor function. 

This therapeutic treatment is for patients experiencing overactive bladder (OAB) symptoms of urinary urgency, urinary frequency and/or urge incontinence. PTNS is generally used after behavior modifications, Kegel exercises and failure of medications.

During the procedure, the patient’s foot is elevated and supported, and a slim needle electrode is placed near the nerve at the ankle, known as the tibial nerve, which is about three to four centimeters in.  A handheld nerve stimulator is then connected to the electrode and sends mild electrical pulses to the tibial nerve. These impulses travel to the sacral nerve plexus, the group of nerves at the base of the spine responsible for bladder function. Intensity of the impulses varies, and is determined by your doctor during the procedure.

By stimulating these nerves, bladder activity can be altered.  As this change happens gradually, patience will receive a series of treatments, typically twelve weekly, thirty minute treatments.  After the treatments, the patients response to the therapy will be assessed, and occasional treatments may be needed to sustain improvements.

Those with pacemakers or implantable defibrillators  should not use PTNS, nor should those who are prone to excessive bleeding, have nerve damage, or pregnant.   

Medicines

There are a number of medications that affect bladder control in different ways, and many can help reduce or prevent leakage.  Some prevent abnormal nerve signals that destabilize the bladder’s muscle contractions, while others relax the bladder or cause irritation or infection to dissipate. 

Surgical Options

Several devices and procedures are available to help stabilize the bladder, urethra, and prostate, with varying levels of non-invasive to surgical procedures open to patients.

Males slings, like their female counterpart, can improve incontinence by providing support for the urethra and ensuring it does not pass urine until the patient consciously decides to do so.

Urinary incontinence caused by underlying prostate issues have a variety of remedies available, ranging from Urolift, which gently moves the enlarged prostate out of the way of the urethra, to more drastic options, such as removal of part of the offending tissue.

An artificial sphincter is a device that mimics the musculature of the sphincter. It is a surgical implanted ring that encircles the urethra, and can me manually inflated to close around the urethra to prevent leakage.  It is not as common, but is very successful in carefully selected patients.

This range of therapies briefly described here should suggest to the reader a single therapy is seldom employed to treat the UI. Instead combinations of these therapies are tailored to meet the condition and needs of the patient after extensive consultation, usually with several specialists in the varying aspects of UI therapy.

How can I prevent male incontinence?

Many events and choices in life can lead to urinary incontinence.  Being overweight, weakened pelvic floor muscles, an unhealthy diet, and even smoking can do it.  Thankfully, behavioral changes can help prevent incontinence. Pelvic muscles are the same as any other muscle: when they get weaker, they can be strengthened and make more efficient.  Men can use pelvic muscle exercises, such as Kegel exercises to regain bladder control. Ask your physician for information on these exercises.