Male Urinary Incontinence

Causes of male urinary incontinence

Some men will experience temporary urinary incontinence from drinks, foods or medications that stimulate the bladder and increase urine production. Alcohol, caffeine, chocolate, chili peppers, artificial sweeteners or carbonated drinks can cause this to occur.

Treatable conditions that can cause urinary incontinence include:

• Urinary tract infection
• Constipation

Urinary incontinence can be a symptom of an underlying condition or changes including:

• Aging bladder muscles can reduce the organ’s capacity to store urine
• An enlarged prostate can lead to urinary incontinence
• Untreated prostate cancer can cause stress or urge incontinence

Risk factors of male urinary incontinence

Your likelihood of developing male incontinence increases as you age but is not a normal part of aging. Several medical conditions can increase your risk for developing male incontinence as you age including:

• Benign prostatic hyperplasia (BPH)
• Bladder cancer
• Urinary tract congenital abnormalities such as birth defects
• Dementia
• External beam radiation that is given to treat prostate cancer
• Urinary tract injuries
• Nervous system injuries
• Overactive bladder
• Stroke
• Kidney stones

Symptoms of male urinary incontinence

Leaking urine is the primary symptom of urinary incontinence. Some people have mild incontinence, while others have severe incontinence.

Types of urinary incontinence include:

• Stress incontinence — urine leakage caused by coughing, sneezing, laughing, exercising or heavy lifting
• Urge incontinence — intense urge to urinate followed by sudden urine loss; urge incontinence can be caused by infection, diabetes or a neurological condition
• Overflow incontinence — constant dribbling when bladder does not empty completely
• Functional incontinence — physical impairment that reduces likelihood of getting to the toilet on time
• Mixed incontinence — mixed incontinence occurs when you have multiple types of incontinence

Diagnosis of male urinary incontinence

Urinary incontinence can be diagnosed in an exam with your doctor. During the exam, your physician will perform a physical exam, take your medical history and order diagnostic procedures.

Your doctor may ask you to keep a voiding diary (log of when you went to the bathroom) to understand your situation.

Other tests include:

• Pad test — determines if the fluid loss is urine and not other fluids
• Urine studies — urine studies, such as a urinalysis, cytology or chemistry 7 profile, may indicate conditions that may cause urinary incontinence
• Post-void residual volume — determines how much urine is left in the bladder after urination
• Cough stress test — your doctor may simulate coughing to determine how much fluid leaks when you cough

Treatment for male urinary incontinence

Treatment for urinary incontinence depends on the severity of your condition. If you have an underlying condition, your doctor will treat your condition first before moving to other treatments.

Behavior treatments

Before moving to more advanced treatments, your doctor will educate you on techniques that can help alleviate symptoms including:

• Bladder training
• Double voiding
• Scheduled toilet trips
• Fluid and diet management
• Pelvic floor muscle exercises

Medications

A variety of medications can be used to treat incontinence including:

• Anticholinergics — calms an overactive bladder
• Mirabegron — relaxes bladder muscle to increase amount of urine the bladder can hold
• Alpha blockers — relaxes bladder and prostate muscles to allow bladder to empty

Medical devices

If medications and behavioral techniques are not effective, your doctor may recommend treatment with a medical device, such as a catheter or collection system.

Interventional therapies

For severe cases of male incontinence, your doctor may recommend interventional therapies such as bulking material injections, botulinum toxin type A (Botox) or nerve stimulators. There are risks and benefits from these procedures, so your doctor will weigh all the options and develop a treatment plan for your case.

Surgical therapies

The most advanced cases of urinary incontinence in men may need surgical intervention.

Surgeries that can correct urinary incontinence include:

• Sling procedures — helps to keep urethra closed to treat stress incontinence
• Bladder neck suspension — provides support to urethra to relieve symptoms
• Artificial urinary sphincter — men may experience symptom relief with this procedure, which is meant to shut the urinary sphincter until you are ready to urinate

Recovery from male urinary incontinence

Recovery from urinary incontinence treatment will depend on the treatment protocol. Many patients experience lifelong symptom relief with behavioral and medical therapies. For those who have more advanced procedures, symptom relief can be achieved, but there could be major side effects.