Male Urinary Incontinence

Male urinary incontinence, is the loss of urinary control or involuntary leakage of urine in men.  In United States, there are a small percentage of males, are affected by urinary incontinence.  Urinary incontinence can be embarrassing and distressing.  However, with proper management, it can be controlled.

There are different types of urinary incontinence, namely:-

Stress Incontinence refers to the leakage of urine when the pressure of the abdomen on the bladder becomes too great for the bladder outlet to withstand.  This causes urine leakage when one sneezes, coughs, exercise or laughs.  This is more common in women whose pelvic muscles are weakened after childbirth.  In men, this can occur after prostate surgery.

Urge incontinence refers to the leakage of urine due to an overactive bladder.  The muscle contracts too early and normal control is reduced.  The patient would normally have an urgent need to go to the bathroom but the urine leaks out before reaching there.

Overflow incontinence refers to the leakage of urine due to a persistent obstruction to the outflow of urine.  The patient is not able to empty his bladder adequately, resulting in the leakage of urine whenever the bladder is full.  The common cause of this is because of enlarged prostate.

Functional incontinence will occur if the patient suffers from dementia where it can prevent the patient from getting to the bathroom in time to pass urine.

The typical symptoms of male urinary incontinence include a sudden urge to urinate, urinating frequently and waking up frequently throughout the night to urinate. 

One’s daily habit like drinking, the underlying medical condition like urinary tract infection, bladder cancer or physical problem like prostate conditions can cause male urinary incontinence.  Neurological conditions like stroke, spinal cord injury, Parkinson disease and multiple sclerosis can affect the nerves involved in bladder control.  Old age can also lead to a decrease in the bladder’s ability to store urine and an increase in overactive bladder symptoms

A doctor will normally do a physical examination like checking for prostate enlargement or nerve injury.  Sometimes, the doctor would order for a urinalysis to rule out infection and haematuria, abdominal ultrasound imaging to detect bladder cancer or stones or urodynamic testing to evaluate the bladder’s activity to store and empty urine effectively.

After the above test had been done and evaluated, the doctor will determine the treatment.  The treatment can be behavioural therapy like limiting the intake of fluids or doing the kegel exercises to strength the pelvic floor muscles, medications to shrink the prostate size and improving bladder emptying or surgery like male sling procedure that help men with weak sphincter muscles.

In conclusion, male urinary incontinence can be managed with lifestyle modifications.  One can reduce the fluid intake to decrease urine and avoid caffeine and carbonated-drinks as these are bladder stimulants.