Male urinary incontinence

Male urinary incontinence

What is male urinary incontinence?

Urinary incontinence – the loss of bladder control – is a common problem which often affects men as they age, often related to changes in the prostate gland. It may result in discomfort during daily life, avoidance of favourite activities, or reluctance to leave the house for fear of having an accident. Incontinence is often a sign of another urinary tract problem.

Sandhurst Urology offers diagnosis, management, and medical intervention for male urinary incontinence from our clinic in Bendigo. To book an appointment, please ask your GP for a referral.


Symptoms of male urinary incontinence

The chief symptom of urinary incontinence is an inability to hold urine, though the reason for being unable to do so and the feeling it produces can vary. The most common types of urinary incontinence are:

  • Stress incontinence – leakage generally occurs when you are active, such as lifting something heavy or walking, but is often also caused by coughing or sneezing. It is often caused by weak pelvic floor muscles and is more common in women.
  • Urge incontinence – leakage caused by a sudden and powerful urge to urinate which cannot be postponed.
  • Functional incontinence – leakage caused by a physical or mental impairment which prevents you from reaching a toilet in time to urinate (such as a movement disorder which affects your coordination and prevents you from unbuttoning your pants in time).
  • Overflow incontinence – incontinence caused by an inability to completely void the bladder during urination, resulting in dripping or dribbling later on. This type is particularly common in men with prostate concerns.

Remember that your own experience with urinary incontinence is individual – you may experience symptoms of multiple types of urinary incontinence at once. For further advice and diagnosis, book an appointment at Sandhurst Urology.

How male urinary incontinence is diagnosed

In most cases, you can effectively diagnose urinary incontinence on your own by identifying urine leakage. Your doctor will then help you access tests to uncover what causes your incontinence and how severe it is, including:

  • Urinalysis – collecting a small sample of your urine, which is sent to a pathology lab and tested for blood or signs of infection.
  • Keeping a bladder diary – your doctor may request recording when you urinate, how frequently, and how often leakage occurs. This can help determine lifestyle elements which trigger incontinence.
  • Urodynamics studies – these assess various aspects of your urinary symptoms, determining how much fluid your bladder can hold and how well the urethral sphincter is working. Sandhurst Urology proudly provides full urodynamics assessment in-clinic.
  • Digital rectal exam – your doctor inserts a gloved, lubricated finger into the anal cavity to feel the prostate, checking for abnormal size or shape. If your urinary incontinence is caused by benign prostate enlargement or prostate cancer, this test may help your doctor identify it.
  • Cystoscopy – using a tiny camera attached to a thin, flexible tube, your doctor inspects the inside of your bladder for abnormalities. The camera is passed into your body through the urethra, usually under sedation or local anaesthetic.
  • Pad test – your doctor may give you a pad to wear inside your underwear, usually for around 24 hours. The pad is weighed after the test is complete to determine the volume of urine lost.

Preventing male urinary incontinence

Some causes of male urinary incontinence – such as age, neurological disorders, and nerve damage – cannot be prevented.

In addition to specific advice provided by your medical team, the following strategies may reduce your likelihood of developing male urinary incontinence:

  • Avoid caffeine and alcohol – these substances can irritate the bladder muscle and exacerbate the overactive symptoms.
  • Maintain an active lifestyle – regular exercise ensures that the pelvic muscles remain strong. Keeping a healthy body weight also reduces pressure on your bladder which may cause it to leak. Males tend to store adipose tissue on the inside of the abdomen, which sits on the bladder, exacerbating bladder symptoms.
  • Avoid smoking – as well as contributing to bladder cancer, smoking often causes repeated coughing can weaken the pelvic floor muscles and lead to leakage. Nicotine also causes the bladder muscle to be over active.
  • Stay regular – as the rectum and prostate are near each other, constipation may place excess pressure on the prostatic urethra increasing the bladder outflow obstructive symptoms. Maintain a healthy diet with plenty of fibre to ensure regular bowel opening.
  • Review your medications – many medications (particularly antidepressants and certain herbal supplements) can increase your urge to urinate or affect how your bladder muscles work. You may wish to ask your doctor about switching treatments if your medications cause urinary incontinence.
  • Get regular prostate exams – men who have benign prostate enlargement or prostate cancer often have urinary symptoms which include incontinence. Regular prostate exams help your doctor identify these conditions in their early stages and reduce or prevent their impact on your continence.
  • Manage other medical conditions – diabetes, neurological disorders, and many other conditions may lead to urinary incontinence if not effectively managed. Speak to your doctor about management strategies that don’t impede your bladder function.

As with any condition, always seek medical guidance to prevent and treat male urinary incontinence effectively. Ask your GP for a referral to Sandhurst Urology for individualised advice.

Treatments for male urinary incontinence

The treatments best suited to managing your incontinence will depend on the type of incontinence you have and its cause. After carefully considering your condition and needs, your doctor may recommend one or more of the following treatments:

  • Medications – your doctor may prescribe anticholinergic medications to help calm overactive bladder muscles, or alpha-blockers to relax muscles and fibres in the bladder neck and prostate. The medication recommended usually depends on your type of incontinence
  • Bladder training – alongside managing your fluid intake, bladder training aims to reduce the amount of times you need to urinate each day. Depending on your goals, it can involve delaying urinating for a specific period of time after feeling the need to go or urinating at specific times of the day whether you feel the need to go or not. The specifics should be discussed with your urological team.
  • Using urinary collection systems – pads, underwear shields, or a specialised collection system which fits over the penis may be recommended to catch urine as it leaves your body. While they do not treat incontinence directly, these strategies can reduce its impact on your day-to-day life.
  • Pelvic floor training – performing certain exercises, under the direction of your doctor or a physiotherapist, to improve the strength of your muscles and lead to improved ability to hold urine. Some men also have an overactive pelvic floor and may require education on how to relax certain sections of the pelvic floor.
  • Intermittent catheterisation – periodically passing a catheter into your bladder to drain it fully can reduce how often it leaks urine. If this is recommended, your doctor will recommend how often to do it and teach you how to do it at home.

Medical interventions for male urinary incontinence

Treatments offered through Sandhurst Urology’s Bendigo clinic include:

  • Botox injections – your urologist injects a tiny amount of Botox into the bladder muscle, forcing it to relax. It may be recommended if your incontinence is caused by bladder contractions.
  • Bulking agents – your urologist may inject small amounts of synthetic material into the tissues around the urethra, placing pressure on it and holding it closed when you are not urinating.
  • Artificial urinary sphincter (AUS) – your urologist surgically places a small, fluid-filled ring around the urethra which connects to a pump implanted in the scrotum. The ring holds the urethra closed and prevents leakage, and you squeeze the pump to deflate it when you need to urinate.
  • Sling procedures – your surgeon positions a mesh-like tape behind part of the urethral bulb, creating a supportive pouch which holds the urethra in position and prevents urine from leaking during activities. Please note that Sandhurst Urology does not perform female sling procedures.
  • Cystoplasty (bladder augmentation) – urinary incontinence caused by an unusually low bladder capacity may be treated with a procedure to make the bladder physically larger.

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