Male Urinary Incontinence

Overview and Facts about Male Urinary Incontinence

Male urinary incontinence, or the involuntary loss of bladder control, affects between 2 and 15 percent of men ages 15 to 64 and 5 to 15 percent of men over 60 not living at a senior assisted living facility.

The four main types of male urinary incontinence are:

• Stress urinary incontinence, which is due to weak pelvic floor muscles allowing urine to escape.
• Urge incontinence, which is characterized by the intense need to urinate that often cannot be controlled.
• Overflow incontinence, which occurs when more urine is made than the bladder can hold or when the bladder is full and cannot empty, thereby causing urine leakage.
• Mixed incontinence, which is a combination of stress and urge incontinence.

Signs and Symptoms of Male Urinary Incontinence

Not all incontinence is long term and many people experience occasional, minor urine leakage. Others may lose small to moderate amounts of urine more frequently. Symptoms vary depending on the type of urinary incontinence:

• Stress urinary incontinence is characterized by leaking urine when exerting pressure on the bladder as when exercising, coughing, sneezing, or lifting something heavy.
• Urge incontinence is characterized by a sudden, uncontrollable urge to urinate followed by involuntary urine loss.
• Overflow incontinence is characterized by frequent or constant dribbling of urine due to the bladder not emptying completely.
• Mixed incontinence includes leaking and a sudden, strong urge to urinate.

Causes and Risk Factors of Male Urinary Incontinence

Urinary incontinence is not a disease but a symptom, and it can be caused by underlying medical conditions or physical problems. Temporary urinary incontinence may be caused by a urinary tract infection, constipation, medications, and even food and drinks that act as diuretics.

Persistent urinary incontinence may be due to changes to the bladder that occur with age; an aging bladder muscle can decrease the bladder's capacity to store urine. Also, involuntary bladder contractions become more frequent with age.

Other causes of frequent incontinence may include an enlarged prostate, prostate cancer or surgery, or an obstruction such as a tumor or urinary stones.

Neurological disorders such as Parkinson’s disease, a stroke, a brain tumor, or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

Tests and Diagnosis of Male Urinary Incontinence

A urologist will begin the diagnosis by asking a series of questions about the symptoms. To help make a definitive diagnosis, a doctor will likely recommend:

• A urinalysis to check for signs of an infection or other abnormalities.
• Keeping a bladder diary to record the times and amounts of urination, along with any incontinence episodes.
• Performing post-void residual measurements, or urinating in a container that measures urine output and checking the amount of leftover urine in the bladder.
• Performing urodynamics - a study of the coordination between the nerves, the bladder and the ability to sense.

Treatment and Care for Male Urinary Incontinence

Treatment depends on the type of incontinence, its severity, and the underlying cause. The least invasive treatments range from pelvic floor exercises to bladder training and taking medication.

Incontinence devices like catheters may also help empty the bladder. For severe stress urinary incontinence, treatment to correct this condition includes an artificial urinary sphincter, and for milder forms of stress urinary incontinence, a male sling. For more information please ask your urologist about these procedures.