Male Incontinence Facts

What is urinary incontinence?

Urinary incontinence is the loss of bladder control, resulting in the accidental leakage of urine from the body. For example, a man may feel a strong, sudden need, or urgency, to urinate just before losing a large amount of urine, called urgency incontinence.
 

Stress urinary incontinence

  • This is the most common type of incontinence after prostate surgery. It happens when the muscle that squeezes the urethra to keep urine in the bladder is weak or damaged, or the nerves that help the muscle work have been damaged.
  • Stress incontinence may cause you to leak urine when you cough, laugh, sneeze, lift heavy objects or exercise. You may sleep through the night without having to get up to go to the bathroom, but leak when you get up in the morning.
  • Going to the bathroom more often is a way to handle stress incontinence.

Anatomy of stress urinary incontinence

In a normal male, the bladder neck and the prostate are closed at rest, as are the muscles of the external sphincter. When the prostate is removed, the bladder neck will no longer be closed at rest and since the prostate has been removed, only the external sphincter is left to control urine. In some men, this is not enough to hold urine back when coughing or sneezing.

Overflow incontinence

When the bladder has a hard time emptying and more urine is made than it can hold, this is called overflow incontinence. Overflow incontinence is usually caused by a blockage or narrowing caused by scar tissue. It also may happen when the bladder muscle is not strong enough to get all the urine out.

Signs of overflow incontinence include

  • Getting up often during the night to go to the bathroom
  • Taking a long time to urinate or having a weak, dribbling stream, with little force
  • You may pass small amounts of urine and not feel that your bladder is empty or you may feel like you have to go to the bathroom but cannot
  • You may also leak urine throughout the day

Urge urinary incontinence

Urge incontinence is also known as an overactive bladder. This condition occurs when the bladder muscle contracts too often without warning and you cannot control it. This can be caused by a prostate infection or bladder irritation from radiation therapy.

With this type of incontinence, even a small amount of urine in the bladder can trigger a strong need to pass urine. Because you cannot hold a normal amount of urine, you have to go to the bathroom a lot and may wet yourself if you don’t get there right away. You may feel as if you have a weak bladder or that liquids go right through you. You may even wet the bed at night.

Anatomy of urge urinary incontinence

As a man ages, it is not uncommon for the prostate to increase in size, causing the bladder to work harder to eliminate urine. When the bladder has to work harder to empty it becomes more irritable, leading to frequent urination, getting up at night to urinate and having the sudden urge to urinate. In severe cases, the urge to urinate can be so drastic that it actually causes a man to leak urine on the way to the bathroom.

In other cases, the nerves that supply the bladder are damaged. When the bladder loses these nerves, it exhibits a similar pattern of irritability that gets worse overtime. In these cases, the symptoms tend to be worse than in those with an enlarged prostate. The bladder can become thickened and it may not be able to hold as much urine. The process of urinating may not be coordinated, so as the bladder squeezes to empty, the sphincter also squeezes.

Causes of urge urinary incontinence

  • Spinal cord injury
  • Certain brain injuries
  • Multiple sclerosis
  • Parkinson’s disease
  • Diabetic neuropathy

How common is urinary incontinence in men?

  • Urinary incontinence occurs in 11 to 34 percent of older men
  • Two to 11 percent of older men report daily UI
  • Although more women than men develop UI, the chances of a man developing UI increase with age because he is more likely to develop prostate problems as he ages
  • Men are also less likely to speak with a health care professional about UI, so UI in men is probably far more common than statistics show

Having a discussion with a health care professional about UI is the first step to fixing this treatable problem.