Urinary Incontinence in men is the unintentional leak/loss of urine. It is not considered a disease, it’s a symptom.
The definition of Urinary Incontinence in men is the unintentional leak/loss of urine. It is not considered a disease, it’s a symptom.
Urine is produced by the kidneys and stored in the urinary bladder.
A tube called the urethra leads from the bladder through the prostate and male reproductive organ to the outside of the body. There is a ring of muscle called the “Urinary Sphincter”, as the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.
When a person feels he needs to urinate, nerve signals commands the muscles in the balder wall to squeeze. This causes the forcing out of urine out of the bladder and into the urethra. At the same time, the bladder squeezes, the urethra relaxes, which allows urine to pass through the urethra and out of the body.
What Causes Urinary Incontinence?
For the Urinary System to do its job, muscles and nerves must work together to hold urine in the bladder and then release it at the right time.
Nerve Problems
Any ailment or injury that damages nerves can lead to urination problems:
Diabetes – it damages the nerves especially if the blood sugar level is uncontrolled for years. This may lead to loss of bladder control.
A brain stroke, Parkinson’s disease, and multiple sclerosis all affect the brain and nervous system. These can also cause bladder emptying problems.
Overactive Bladder – a condition in which the bladder squeezes at the wrong time. The condition may be caused by nerve problems, or it may occur without any clear cause. Patients with overactive bladder may suffer from urinary frequency (frequent urination day and night), urgency (sudden urge to urinate straightaway), and urge incontinence (urine leakage that follows a sudden, strong urge to urinate)
Spinal cord injury may negatively impact the process of bladder emptying through the interruption of nerve impulses needed for bladder control
Prostate Problems
Benign Prostatic Hypertrophy (BPH) – as the prostate enlarges, it may squeeze the urethra and affect the flow of the urinary stream. The ensuing symptoms vary, but the most common ones are hesitancy, weak stream; urgency and leaking or dribbling; frequent urination, especially at night; and urge incontinence.
Radical Prostatectomy (surgical removal of the entire prostate gland) – it can lead to erectile dysfunction and incontinence.
Obstruction
A tumor anywhere along the urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones sometimes may lead to urine leakage.
How to Diagnose Urinary Incontinence?
It is imperative to determine the type of urinary incontinence as this information will guide treatment decisions.
Diagnosis of Urinary Incontinence in men will involve a medical history and physical exam and may include keeping a bladder diary (for several days the patient records how much he has drunk when he urinates, the amount of urine produced, whether he had an urge to urinate and the number of incontinence episodes. In addition to urine analysis and post-void residue measurement, special investigations may be needed for proper diagnosis. It includes Urodynamic testing, pelvic ultrasound, and Cystoscopy.
Is Urinary Incontinence Treatable?
Treatment for Urinary Incontinence depends on the type of incontinence, its severity, and the underlying cause. No single treatment works for everyone.
Many men regain urinary control by changing a few habits and doing exercises to strengthen the muscles that hold urine in the bladder. If these behavioral treatments do not work, the patient may be advised to take certain medications.
In some cases, surgery is the only appropriate choice.
The treating Urologist will discuss with the patient all treatment options available, which include:
Behavioral Techniques
Bladder Training – to postpone urination after the patient feels the urge to. The aim is to lengthen the time between trips to the toilet.
Double voiding – it means urinating, then waiting a few minutes and trying again. This is intended to help the patient learn to empty his bladder more completely to avoid overflow incontinence.
Scheduled toilet trips – urinating regularly every two to four hours rather than waiting for the urge to go.
Pelvic floor muscle exercises – aims at strengthening the muscles that help control urination. Known as Kegel exercises, these techniques help strengthen weak pelvic muscles and improve bladder control. The person contracts the muscles used to retain urine and holds the contraction for 4 to 10 seconds, then relaxes the muscles for the same amount of time. It may take weeks or months of regular pelvic exercise to show improvement.
Medical Treatment
Medicines can impact Urinary Bladder Control in several ways.
Some medications help prevent incontinence by blocking abnormal nerve signals that make the bladder contract at the wrong time, while others slow the production of urine. Others would relax the bladder. The treating Urologist would be able to choose the most suitable type of medication according to his patient’s medical status
Surgical Treatment
If other treatments fail to control symptoms, there are certain surgical procedures that can treat the problems inducing urinary incontinence.