Male Incontinence

Overview of Male Incontinence (Urinary Leakage)

Understanding Male Incontinence

Male incontinence, or urinary leakage, can be caused by a variety of factors. Medical conditions like an enlarged prostate gland, diabetes, obesity, history of radiation, surgery for prostate cancer or bladder cancer or even certain medications can cause incontinence.

There are three major types of this condition: stress incontinence, urge incontinence and mixed incontinence, which is the combination of both.

What is stress incontinence?

Stress incontinence is the release of urine when you have increased intraabdominal pressure, like when you laugh, cough, lift or do other activities that increase pressure on the pelvis. This often results from problems with the bladder, which stores urine, or the sphincter, which is the muscle encircling the urethra, or the tube that carries urine out of the body. Obesity, diabetes, pelvic surgery and neurologic conditions commonly cause this difficulty.

What is urge incontinence?

Urge incontinence is the sudden urge to urinate, which may result in discharge of urine before reaching a bathroom. Diabetes, disease and irritation of the bladder, prior surgery on the prostate, infections and nervous system disorders commonly cause this problem.

Diagnosis

Sometimes physicians can diagnose urinary incontinence by reviewing a history of your urinary problems. In other cases, they may need to perform urodynamic testing. This type of testing uses electrode patches placed on your body that allow your physicians to monitor your bladder, urine flow and volume of leakage during the test. Your physicians can often determine the best treatment options using this information. Other times, it may be helpful to perform a cystoscopy, in which a small scope is passed through the urethra (urine channel) into the bladder to evaluate the bladder and prostate to determine the cause of your leakage.

Treatments for Male Incontinence (Urinary Leakage)

Men with incontinence often use absorbent pads to soak up urine. The appropriate incontinence treatment for you depends on the number of pads you use each day. If you use a small number of pads, you may decide to simply continue using them. The more pads you use each day, the more interested you may be to seek treatment. Your physicians will help you understand your options so you can make the right decision for you.

Treatments your physicians may suggest include:

• Strengthening exercises. When weakness of your pelvic floor, bladder or sphincter muscles causes incontinence, and your nerves and blood vessels are healthy, exercises to strengthen the muscle may control urination. You can do these (Kegel) exercises many times a day to regain urinary control over time. Your doctor may refer you to a pelvic floor physical therapist.
• Condom catheter. This urine collection device slips over the penis and secures at the base. A tube at the end of the catheter connects to a bag that collects urine. You can strap the bag to one leg, allowing some freedom of movement. This option is less likely to cause urinary tract infections than urethral catheters.
• Penile clamp. This specially designed device compresses the penis, constricting the urethra. When the clamp releases, urine flows freely.
• Male sling. This device involves a piece of mesh implanted around the urethra to help hold back urine. It works by compressing the urethra enough to regain urinary continence. In an outpatient procedure, the surgeon anchors the sling to muscles or bone in the pelvis.
• Artificial sphincter. A cuff is surgically placed around the urethra and connected to a bulb beneath the skin of the abdomen. Using a pump placed inside your scrotum, you inflate the cuff, which compresses the urethra to stop urine flow. To urinate, you press the bulb to deflate the device. This is done in an outpatient surgery setting.
• InterStim device. If your leakage is due to nerve issues, you may have a device implanted into the lower back that stimulates the nerves of the bladder to help with incontinence. This is done in an outpatient surgery setting.
• Medicines. If uncontrollable urges to urinate cause your incontinence, you can use medicines to reduce these urges. Some medications block nerve impulses and signal the bladder to contract. Medicines that slow the production of urine can also reduce urge incontinence. Some medications relax the bladder or shrink the prostate, which can reduce bladder spasms and relieve urge incontinence.

Your incontinence may also be caused by a combination of bladder and sphincter problems. Your physicians may combine treatments to provide the degree of control you need.

Research

IU Health physicians’ ongoing research into new treatments for incontinence demonstrates their commitment to helping men recover from these conditions.

IU Health has ongoing clinical studies of incontinence outcomes and research into congenital urinary conditions and treatments, such as artificial sphincters.