Urinary Incontinence in Men
Topic Overview
What is urinary incontinence in men?
Urinary incontinence is the accidental release of urine. It is not a disease but rather a symptom of a problem with a man's urinary tract
.
Urine is produced by the kidneys and stored in a muscular sac called the urinary bladder. A tube called the urethra, which is surrounded by a special ring of muscles called the urinary sphincter, leads from the bladder through the prostate and penis to the outside of the body. As the bladder becomes filled with urine, complex nerve signals ensure that the sphincter stays contracted and the bladder stays relaxed. This interaction between nerves and muscles prevents urine from leaking out of the body.
During urination, nerve signals cause the muscles in the walls of the bladder to contract, forcing urine out of the bladder and into the urethra. At the same time the bladder contracts, nerve signals cause the muscles surrounding the urethra to relax, allowing urine to pass through and out of the body.
Incontinence may occur if the bladder suddenly contracts or if it doesn't contract when it should, leading to a buildup of too much urine in the bladder, which can cause leakage. Incontinence may also occur if the muscles around the urethra are damaged or suddenly relax or if the urethra is blocked, keeping urine from draining properly and causing eventual leakage around the blockage.
Incontinence affects 13 million Americans and occurs twice as often in women as in men.1 Although incontinence occurs more often in older men than in young men, it is not considered a normal part of the aging process.
How is urinary incontinence in men classified?
Urinary incontinence may occur for only a short time (acute) or may become an ongoing problem (chronic). Acute incontinence is often related to other medical problems and treatments. This topic will focus on types of chronic urinary incontinence.
- Stress incontinence occurs when you sneeze, cough, laugh, lift objects, or do other activities that increase stress on your bladder.
- Urge incontinence is an urge to urinate that is so strong that you often cannot make it to the toilet in time. Urge incontinence occurs when your bladder contracts when it shouldn't. This can happen even when you only have a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence. Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.
- Overflow incontinence is leakage that occurs when the bladder fails to empty properly, due to a blockage or weak bladder muscle contractions. Obstruction is usually related to either enlargement of the prostate or narrowing of the urethra from scar tissue.
- Total incontinence is a continual leakage of urine due to loss of sphincter function.
Functional incontinence is a rare form of urinary incontinence related to physical or mental limitations that restrict a man's ability to reach the toilet in time.
What causes urinary incontinence in men?
Urinary incontinence occurs when the muscle (sphincter) that holds your bladder's outlet closed is not strong enough to hold back the urine. This may happen if the sphincter is too weak, if the bladder muscles contract too strongly, or if the bladder is overfull. In men, urinary incontinence often is related to a problem or a treatment involving the prostate gland, such as enlargement of the prostate (benign prostatic hyperplasia, or BPH).
- Stress incontinence may develop when a man's prostate gland is removed and there has been dysfunction of or damage to the nerves or the sphincter, resulting in inadequate support for the lower bladder (bladder neck). The sphincter must then do all the work of maintaining continence, and the extra pressure (stress) of sneezing, coughing, or straining forces urine past the sphincter and through the urethra.
- Urge incontinence is caused by bladder contractions that are too strong to be stopped by the sphincter, causing an irresistible need to urinate. In many cases, the cause of urge incontinence and overactive bladder cannot be determined, but sometimes it can be traced to urinary tract infections, early BPH, interstitial cystitis, or early bladder cancer.
- Overflow incontinence is usually caused by a blockage of the urethra that forces urine to build up in the bladder. Often the blockage stems from an enlarged prostate gland (benign prostatic hyperplasia) or a narrowing of the urethra. Eventually the pressure from the full bladder forces excess urine past the obstruction. Overflow incontinence may also occur because of muscle weakness of the bladder.
Urinary incontinence can sometimes be aggravated by drinking alcohol or by taking diuretics, antidepressants, sedatives, narcotics, or nonprescription cold or diet medicines.
What are the symptoms?
The main symptom of urinary incontinence is the accidental release of urine. Additional symptoms will vary depending on the type of urinary incontinence.
- Stress incontinence: Unintentional release of a small amount of urine occurs with coughing, straining, lifting, or changing posture.
- Urge incontinence: The need to urinate is so strong that you cannot reach the toilet in time.
- Overflow incontinence: You have uncontrolled dribbling of urine, or you have the urge to urinate but can only release a small volume of urine.
How is urinary incontinence in men diagnosed?
Your medical history and a physical examination, along with some simple diagnostic tests such as a urinalysis, often provide enough information for your health professional to determine the cause of your incontinence. Additional tests called urodynamics may be needed if the incontinence is caused by more than one problem or if the cause is unclear.
How is it treated?
Incontinence is usually treatable with medicines, specific exercises, or surgery, after a health professional has determined what is causing the problem. Treatment varies based on the type of incontinence and how much it is affecting your life.
Incontinence can be an embarrassing problem, and men are sometimes reluctant to seek help. Some men might find it more of a problem than others and choose more aggressive treatment. Most men don't require surgery to treat their symptoms. All men with symptoms of urinary incontinence should see their health professional.
Frequently Asked Questions
Learning about urinary incontinence:
Being diagnosed:
Getting treatment:
Ongoing concerns:
Living with urinary incontinence:
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| Author: | Ralph Poore | Last Updated: August 10, 2006 |
| Medical Review: | Martin Gabica, MD - Family Medicine Avery L. Seifert, MD - Urology | |
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