Male Incontinence

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Male incontinence refers to the involuntary loss of urine in men, a condition that can be disruptive and significantly impact a man’s quality of life. It can affect men of all ages and is often associated with underlying medical issues or age-related changes in the urinary system.

At the University of Kansas Department of Urology, our primary emphasis lies in delivering advanced healthcare and tailoring treatment plans to suit individual needs. Our expert urologists employ state-of-the-art technology for the diagnosis and management of male incontinence and a range of urological disorders. Our commitment is centered on your overall wellness, and we offer compassionate care to improve your quality of life.

Types of Male Incontinence

  • Stress Incontinence: This occurs when there is pressure on the bladder, such as when coughing, sneezing, laughing, or lifting heavy objects, leading to urine leakage. It is often caused by weakened pelvic floor muscles or a malfunctioning sphincter.
  • Urge Incontinence: Also known as overactive bladder, this type is characterized by a sudden and intense urge to urinate, often followed by involuntary leakage. It may result from an overactive detrusor muscle or neurological issues.
  • Overflow Incontinence: In this type, the bladder doesn’t empty properly, leading to frequent dribbling or a constant trickle of urine. It can be caused by an obstruction (e.g., enlarged prostate), nerve damage, or weak bladder muscles.
  • Functional Incontinence: This type is not directly related to bladder or urinary tract problems but is due to physical or cognitive limitations that prevent a person from reaching the toilet in time.

SYMPTOMS & CAUSES

Symptoms

The primary symptom of male incontinence is the involuntary loss of urine. However, the severity and frequency of leakage can vary. Other common symptoms may include:

  • Frequent urination (more than eight times a day)
  • Urgency to urinate
  • Difficulty starting urination
  • Weak urine stream
  • Dribbling or post-void dribbling
  • Feeling of incomplete bladder emptying
  • Waking up multiple times at night to urinate (nocturia)

Causes

Male incontinence can have various underlying causes, and sometimes, a combination of factors may contribute to the condition. Some common causes include:

  • Prostate Problems: Enlarged prostate (benign prostatic hyperplasia) or prostate cancer treatments can affect the urinary system and lead to incontinence.
  • Neurological Conditions: Diseases like multiple sclerosis, Parkinson’s disease, or spinal cord injuries can disrupt the signals between the brain and the bladder, causing incontinence.
  • Pelvic Floor Muscle Weakness: Weakened pelvic floor muscles, often due to aging, obesity, or previous surgery, can result in stress incontinence.
  • Medications: Certain medications, such as diuretics, alpha-blockers, or sedatives, can affect bladder control.
  • Infections: Urinary tract infections (UTIs) can cause temporary incontinence.
  • Bladder Abnormalities: Conditions like bladder stones or bladder cancer can lead to incontinence.
  • Injury or Surgery: Trauma to the pelvic area or previous surgeries involving the bladder or prostate can result in incontinence.
  • Chronic Cough: Conditions like chronic obstructive pulmonary disease (COPD) can lead to stress incontinence due to the constant pressure on the bladder from coughing.

DIAGNOSIS & SCREENING

Diagnosing male incontinence typically involves a thorough medical evaluation by a healthcare professional. The process may include:

  • Medical History: Your doctor will ask about your symptoms, medical history, medications, and any recent surgeries or injuries that could be contributing to the condition.
  • Physical Examination: A physical examination, including a genital and rectal examination, may be performed to assess the health of the prostate and pelvic muscles.
  • Urinalysis: A urine sample may be analyzed for signs of infection or other abnormalities.
  • Bladder Diary: Keeping a bladder diary, where you record your daily fluid intake, urination frequency, and instances of leakage, can provide valuable information about your condition.
  • Urodynamic Testing: This set of tests measures bladder function, including pressure, capacity, and muscle strength. It helps determine the type of incontinence and its underlying causes.
  • Imaging: In some cases, imaging tests like ultrasound, cystoscopy, or MRI may be used to assess the bladder and urinary tract.

TREATMENTS

The treatment of male incontinence depends on the type, severity, and underlying cause. Common treatment options include:

  • Lifestyle Modifications:
    • Dietary changes to avoid bladder irritants (caffeine, alcohol, spicy foods).
    • Scheduled voiding to train the bladder.
    • Weight management and regular exercise to improve overall health.
  • Pelvic Floor Exercises (Kegels):
    • These exercises can strengthen the pelvic muscles and improve bladder control. A physical therapist may provide guidance.
  • Medications:
    • Anticholinergic drugs for overactive bladder.
    • Alpha-blockers or 5-alpha-reductase inhibitors for prostate-related incontinence.
    • Topical estrogen therapy for men with incontinence due to low estrogen levels.
  • Medical Devices:
    • Penile clamps or compression devices to control urine flow.
    • Urethral inserts or pessaries to block urine leakage.
  • Surgical Interventions:
    • Sling procedures to support the urethra.
    • Artificial urinary sphincter implantation for severe stress incontinence.
    • Prostate surgery or minimally invasive treatments for prostate-related incontinence.
  • Neuromodulation:

OUTLOOK & PROGNOSIS

The outlook for male incontinence varies depending on the type and cause, as well as the individual’s response to treatment. Many men can significantly improve their symptoms and quality of life with appropriate interventions. However, in some cases, complete resolution of incontinence may not be achievable.

For example, lifestyle modifications and pelvic floor exercises can be very effective for mild cases, while more severe cases may require surgical interventions. Prostate-related incontinence often improves following prostate surgery, but it may take time. Overactive bladder can be managed with medications and lifestyle changes.

Prevention & Management

Preventing male incontinence and effectively managing the condition involves a combination of preventive measures and ongoing strategies. Here are some key points for prevention and management:

Prevention:

  • Healthy Lifestyle: Maintaining a healthy weight through diet and exercise can reduce the risk of obesity-related incontinence.
  • Prostate Health: Regular check-ups and early treatment for prostate issues can help prevent prostate-related incontinence.
  • Pelvic Floor Exercises: Even if you don’t currently have incontinence, practicing pelvic floor exercises (Kegels) can help strengthen your pelvic muscles and potentially reduce the risk of developing incontinence in the future.
  • Hydration: While it’s essential to stay hydrated, avoid excessive fluid intake close to bedtime to minimize nighttime urination.

Management:

  • Medical Evaluation: Seek prompt medical evaluation if you experience symptoms of incontinence. Early diagnosis and intervention can lead to more effective treatment.
  • Lifestyle Modifications: Adjust your lifestyle as needed, including dietary changes to avoid bladder irritants, scheduled voiding, and maintaining a healthy weight.
  • Pelvic Floor Exercises: If recommended by a healthcare provider, practice Kegel exercises regularly to strengthen pelvic muscles.
  • Medications: Take prescribed medications as directed, especially if you have overactive bladder or prostate-related incontinence.
  • Medical Devices: Properly use any medical devices or aids recommended by your healthcare provider, such as penile clamps or compression devices.
  • Surgical Interventions: If surgery is recommended, discuss the potential risks and benefits with your surgeon and follow post-operative instructions closely.
  • Support and Education: Seek support from healthcare professionals, support groups, or specialists in male incontinence management to better understand and cope with your condition.

CONCLUSION

Male incontinence can significantly impact a man’s quality of life, but with the right approach, it can be effectively managed or even prevented. Early diagnosis and a tailored treatment plan are crucial for achieving the best possible outcome.

Remember that you are not alone in dealing with this condition, and there are healthcare professionals and resources available to help you manage and cope with male incontinence.

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