Incontinence may be more common in women, but many men experience it too. Read on to learn more about incontinence in men, and how to treat it.
What is incontinence?
The official definition of incontinence is the inability to hold urine, resulting in bladder leakage.
Men are more likely to get incontinence as they age, with 11% having incontinence between 60-64 years of age, and 31% of older men experiencing the condition.
In men, incontinence may happen for a variety of reasons. Many men with incontinence also experience prostate issues. An enlarged prostate can place pressure on the bladder, leading to sudden, and frequent urination. An enlarged prostate may also lead to difficulties completely emptying the bladder, which can lead to bladder leaks and accidents.
Men may also experience stress urinary incontinence, which is the inability to hold urine due to weak pelvic floor muscles. This can often occur after prostate surgery, to remove the prostate, but may also happen when repeated stress is placed on the pelvic floor.
Other reasons men may experience incontinence are:
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Obesity
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Chronic cough, or repeated pressure placed on the pelvic floor, leading to weakened muscles.
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Nerve damage
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Neurological disorders
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Constipation
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A blockage in the urinary tract
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Prostate cancer
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Loss of sphincter strength
How is it diagnosed?
Upon talking to your doctor about your symptoms of incontinence, your doctor will likely perform a number of tests and exams in order to determine the root cause of the incontinence.
Your doctor will perform a physical examination to determine if there are any problems he or she can identify that might be causing your incontinence. During this time, your doctor may also conduct a digital rectal exam, in order to determine an enlarged prostate or to uncover any blockages that may exist. Finally, urine and/or blood tests may be taken to test for any other underlying conditions.
Your doctor may also ask you to keep a bladder diary for several days. This type of diary tracks your diet and drink intake, as well as any leaks that may occur, and what you were doing at the time. Often, this may identify patterns of when you are experiencing leaks, and can help you and your doctor determine diet or behavioral changes that may be beneficial in reducing bladder leaks.
Are there different treatment options for men than women?
Many of the treatments offered to women may also be used by men. Common treatments include
Diet and exercise changes.
Keeping a healthy diet, while also avoiding bladder irritants may help to alleviate some of your bladder leaks. Additionally, maintaining a healthy weight with exercise can help to decrease pressure that is placed upon the bladder, and improve core muscle strength. Your doctor may also suggest that you limit your fluids or timing them to better control when you need to go.
Kegels.
Often talked about for women, male kegels have been shown effective at reducing incontinence by increasing the strength of the pelvic floor. (Learn how to do male kegels here.)
Bladder retraining.
Just as any muscle can be trained, so can your bladder. Bladder retraining requires you to time your trips to the toilet, actively delaying them each time you need to go so that over time, you’re bladder grows stronger and you’re able to control the urge to go for longer.
Medications and Injections.
Many people use medications or injections to address bladder leaks. Most of these medications work by calming the bladder muscles to reduce leaks.
If your incontinence is due to an enlarged prostate, your doctor may also prescribe a medication to treat that, which will in turn help with incontinence as well.
Advanced treatment options.
Some non-invasive procedures have been shown to improve bladder leaks in men and women. Nerve stimulation can help improve bladder function by delivering an electric current to specific nerves in order to control bladder function. This type of treatment is usually done in a doctors office and is typically tried after other options have failed.
Surgery.
Finally, various surgical procedures may be used to treat incontinence in men, depending on the type of incontinence, and the root cause.
An artificial urinary sphincter balloon allows you to control your urination with a valve that is place under your skin, which inflates and deflates a small balloon.
Male slings are also used to alleviate incontinence by implanting a mesh material underneath the urethra in order to elevate and apply a gentle compression, preventing urine leakage.
For those who have a very enlarged prostate, or prostate cancer, a prostatectomy may also be performed to remove the prostate. This may cause temporary bladder leakage, but typically does go away several weeks after surgery.
Products specifically for men
Guards.
Just like women, men have access to a variety of absorbent liners, pads and underwear. However, men also have several other options of disposable products. Guards are small elasticized pouches that provide a cup-like fit for protection and comfort. They are held in place by an adhesive strip and worn with close-fitting underwear.
Condom Catheters.
This is a special type of catheter that looks like a condom with a hole in the end of it. They collect the urine as it drains out of your bladder and direct it to a collection bag strapped to your leg.
Where do I start?
Knowing where to start with incontinence treatment is hard, and can be overwhelming. The first step is to make an appointment with your doctor to understand the type of incontinence you have, the cause of your incontinence and what treatment options might be best for you.
In the meantime, check out our Getting Started guide here on nafc.org and learn the steps you can take to reduce bladder leakage before you even get in to see your doctor.
2 Responses
When I first wore briefs for bedwetting, they were made of pulp, the tapes could not open, they had no leak guards, they leaked, they were uncomfortable and they had no odor control. One brief did not last the night. As the 90s moved on, adult briefs became better; attends actually contained a bm and two bladder voids. Then came abena and tena and molicare purple. tranquility had leak guards for men and could take a bowel void. They were fairly cheap and an excellent product – no clumping and cool feeling. Today I use seni, wellness superio, tena slip maxi, attends premier, and tranquility. They are all geared to men whereas brief a long time ago were geared for woman. Many men now wear briefs full time. There are many men with disabilities which require bowel containment. For those who work, the goal is a plastic brief which can contain odor from a bm for a while. Using gary active briefs over them every day makes it possible to handle bowel movements in public or while traveling. It also means one can sleep through a mess. Northshore colored briefs are great for this purpose and don’t chafe while moving around. THe plastic cover conceals the contents worn and in trash. It would be helpful is adult briefs had an odor indicator so the wearer can know if she smells. It’s very embarrassing when everyone around you knows you shit yourself.
Excellent information! As a registered nurse in the long term care space, I’ve used many treatments over the years and am always looking for better options. Guards and condom catheters are a good option, I would like to also offer external catheters like Men’s Liberty. It adheres to the anatomy to keep my patients dry. They can wear one unit all day and they can use their insurance to cover it.