Urinary incontinence is the medical term used to describe not being able to control the flow of urine from your body. Urinary incontinence is not a disease or a normal consequence of aging but a symptom with many possible causes. Most cases of urinary incontinence can be cured or improved. Recent reports have shown that as many as 9-13% of American men suffer from urinary incontinence.
The Root of the Problem
Male continence is maintained by two sphincters: internal and external. The internal sphincter is part of the bladder neck and is under involuntary or reflex control by the brain. The external sphincter, which is part of the pelvic floor muscles, is a voluntary sphincter and is actively relaxed at the time of urination. Male urinary incontinence can be classified into four different categories:
Occurs when you leak urine during physical activity such as exercise, walking, lifting, coughing, and sneezing.
This occurs when you have an overwhelming need to urinate and are not able to hold urine long enough to reach the toilet.
A combination of stress and urge incontinence, where you have symptoms of both conditions.
When your bladder never completely empties which causes urine to leak. This type of incontinence is found in men with prostate enlargement, scars/strictures of the urethra or bladder neck, and can also be due to dysfunctional bladder function, as seen in diabetic patients. Oftentimes during a radical prostatectomy or bladder neck surgery such as TURP, the internal sphincter is removed or damaged. In these situations, the man must rely entirely on the external sphincter to maintain continence. Unfortunately, the external sphincter may be damaged as well during these same types of surgeries rendering the patient incontinent.
Take Back Your Life
Incontinence can be embarrassing and cause men to avoid social situations out of fear of leaking or not making it to the bathroom in time. The day-in-day-out stress and worry of accidents can also take a toll on mental health. Consulting with a medical professional and getting help with this highly treatable condition will improve your mental and physical health.
Diagnosis of the specific type of incontinence in men can be more complex than in women. Your consultation at El Camino Urology in Mountain View, California, will include a detailed medical history and physical examination. Dr. Karpman may request a journal or log to determine the nature and degree of incontinence, as well as triggering factors such as alcohol, coffee or tea, or spicy, sugary, or acidic food. It is essential to rule out simple causes of male urinary incontinence, such as urinary tract infection with a formal urine culture, non-invasive flow rate, and residual urine measurement. Additional testing should include complex urodynamics and cystoscopy. Once the tests have been run Dr. Karpman will discuss the best treatment options and answer any questions you have.
Live Your Life With Confidence
Whether your treatment is surgical, non-surgical, or lifestyle changes, the male incontinence treatment should improve urination control. Patients also report an increase in confidence and an improvement in their general well-being.
The Right Treatment for You
There are four different treatments available for male incontinence:
Bladder retraining is typically recommended for the frail and elderly. Men go to the bathroom at specific times of the day, and times are gradually extended to longer intervals. This type of therapy is effective in treating urge and mixed incontinence.
Depending on symptoms, medications can be given to help men with incontinence. Anticholinergic agents can be used as first-line treatments for urge incontinence because they inhibit detrusor contraction and may help increase bladder capacity. Stress incontinence is typically treated with surgery.
Biofeedback/Electrical Stimulation is practiced to help people gain awareness and control of their urinary tract muscles. The principle of biofeedback is simple: a variety of instruments are used to record small electrical signals that are given off when specific muscles are squeezed to urinate. These muscle squeezings are then converted into audio (hearing) and/or visual (seeing) signs that patients can recognize and learn in order to control muscular activity. With biofeedback, weak muscles can be better activated on demand, overly tense muscles can be relaxed, and overall muscle activity can be coordinated.
Surgical procedures are available to treat male urinary stress incontinence:
In Good Hands
Treatment recovery and aftercare will be determined by the type of treatment that is recommended. Dr. Karpman will discuss recovery and aftercare in the consultation, as well as answer any questions you may have about the recommended procedure.
Yes, though some more severe cases of male incontinence may require surgery. Some non-surgical treatments include lifestyle changes to diet, retraining, and a voiding regime, and strengthening the pelvic floor with Kegel exercises. They aren’t just for women!
While it might seem like a rare condition, as many as 30% of older men have incontinence issues.
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2490 Hospital Drive, Suite 210, Mountain View, CA 94040