Urinary Incontinence in Men

Urinary Incontinence in Men

Authored by DesiMD Doctor on 8 May 2014 - 14:16

Urinary incontinence (UI), bladder control problem is the one of the most common problems seen in men which is characterized by accidental leakage of urine.

Both males and females have different risks for developing UI at different ages. It is more commonly seen in adult women than in men because of the differences in the anatomy of the pelvic region and also because of the many changes that pregnancy and childbirth, bring in women. The structure of male urinary tract is the reason for relatively lower cases of urinary incontinence in men compared to women. It happens more often in older men than in young men. But it's not just a normal part of growing older.  UI can be treated.

What are the bladder control problems?

The conditions that affect either of the two major functions of bladder: storage and emptying of urine are known as bladder control problems. You are not alone suffering from this problem, scores of people experience bladder control.

Urinary incontinence is mainly of three types:

  1. Stress incontinence is the uncontrolled loss of urine during actions such as coughing, sneezing, and lifting, which put abdominal pressure on the bladder.
     
  2. Urge incontinence is the uncontrolled loss of urine following an overwhelming urge to urinate that cannot be stopped.
     
  3. Overflow incontinence is the constant dribbling of urine usually associated with urinating many times in small amounts.

Urine and the urinary bladder

Urine is made by the kidneys and stored in a hollow, balloon-shaped organ, known as urinary bladder, which is located in the lower abdominal area. A tube called the urethra follows the bladder through the prostate and penis to the outside of the body.

How is it caused?

  • Any disease or injury that damages nerves can lead to urination problems due to incorrect signaling.
     
  • Prostate is a male gland similar to a walnut in its size and shape, surrounding the urethra just below the bladder. If it is enlarged/ removed, it will affect the flow of urine by squeezing / relaxing the urethra.
     
  • If the muscles around the urethra are damaged or weakened, urine may leak out at the wrong time.
     
  • If something is blocking your urethra or by any reason your bladder doesn’t empty when it should, urine can build up in the bladder leading to leakage.

Is your bladder under control?

If urine is leaked when you are not ready for it/ asleep

If your urine stream is weak

If you need to strain while urinating

If you feel sudden urgency of urination often at night

If you experience these symptoms, you are suffering from bladder control problem

How is it diagnosed?

The doctor will probably ask details about fluid intake and trips to the bathroom. He may physically examine the prostate gland for any abnormality in its size or damage to nerves. Ultrasound or Urodynamic testing may also be used.

Is it curable?

Yes, it is curable. Starting with simple techniques; exercise and lifestyle modifications are considered as the first line of therapy. Many men succeed in regaining urinary control by modifying few habits and doing exercises to strengthen the muscles that hold urine in the urinary bladder. Kegel exercise is key to controlling the bladder. The following four simple steps may guide you in performing kegel exercise:

Step 1: Find the right muscles

The muscles which you often use to stop passing a gas in case of acidity plays a vital role in improving your bladder control symptoms.

Step: Squeeze the muscles

Squeeze these (pelvic) muscles; you are going the right way if you sense a 'pulling' feeling.

Step 3: Relax other muscles

Do not contract other muscles or tighten your stomach, don’t even hold your breath.

Step 4: Start the countdown

Pelvic muscles should be squeezed for a countdown of 3, and then relaxed for a countdown of 3. Three sets of this exercise should be done with 10 repeats in each set.

 

Initially, this exercise should be performed in a lying position, as it does not require additional energy for pelvic muscles to act against gravity. After few days, this exercise can be performed in sitting or standing position.

Tips for daily lifestyle

Diet to be followed

§  Set a schedule for urinating every 3-4 hours.

 

§  In case of urgency, mental tricks such as counting can be used to take your mind off the urine urgency.

 

§  If you are experiencing urine urgency problems, you can wear clothes which are easy to remove.

 

§  Try to relax while urinating in a standing position.

 

§  Double voiding can also be practiced, which involves urinating as much as possible, followed by a relaxation time and then urinating again.

 

§  Lose weight, if you are obese, as extra weight may put further pressure on the bladder.

Follow

§ Add fibre food in your diet to prevent constipation.

 

§ Do not reduce fluids in a worry of leakage; however limit excess fluids before visiting a place where there is no facility for urinating.

 

§ Drink apple, grape, cranberry and cherry juices to make your urine more acidic which may help in minimizing the risk of urinary tract infection.

Avoid

§ Caffeine containing drinks, soft drinks and alcoholic beverages should be avoided as it may worsen the symptoms.

 

§ Nicotine irritates the bladder; quit smoking if you are a smoker.

 

§ Foods such as citrus fruit, chocolate, tomatoes, vinegars, spicy foods, dairy products, and aspartame irritate the bladder and hence should be avoided.

Medicinal Treatment:

If life style modifications are not enough to control your bladder functions, you may be prescribed one or multiple medications from the following:

Drug category

Action

Anti-cholinergics

Calm the nerves that control bladder muscles & increases capacity of the bladder.

Alpha blockers

Relax the muscles of prostate.

5 Alpha reductase inhibitors

Inhibits the production of male hormone DHT (which causes prostate enlargement), thereby preventing compression of urethra.

Imipramine (Anti-depressant)

It relaxes muscles and block nerve signals that might cause bladder spasms.

Anti-Spasmodics

Relieves spasms

Botulinum toxin (Botox)

May help in relaxing the muscles, needed every 3 months.

Used only when other treatments fail.

 

Surgical Treatment:

There are certain surgical procedures which can be opted when all other options fail. These are:

Artificial sphincter: An artificial sphincter is implanted in your penis, which keeps your urethra closed until you are ready to urinate.

Male sling: A strip of material is wrapped around the urethra by surgical means and the ends are tied to the pelvic bone. This sling keeps constant pressure on urethra thereby closing it until the patient consciously releases the urine.

Urinary diversion: If the bladder function is lost completely due to nerve damage, a urinary diversion is made to pass the urine out of the body. A piece of small intestine is removed and a reservoir is created to which the ureters are directed. An opening on the lower abdomen is also created by the surgeon to drain the urine through it into a bag.

Despite the high cases of bladder control problems, only a small number of patients seek medical attention. Most people withhold their problem due to one of the two main reasons: either they are embarrassed or they are unsure of treatment options. Bladder control problems should not cause embarrassment, as these are medical problems just like arthritis and diabetes. A urologist can help you find a solution.

“In order to succeed, your desire for success should be greater than your fear of failure.

 

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.