Male Urinary Incontinence: Causes, Impact, and Treatment Options - Dr Pramod Krishnappa
Incontinence is defined as any involuntary leakage of urine. Male urinary incontinence is usually caused by a damaged sphincter or an improperly functioning bladder. The sphincter is the circular muscle that controls urine flow out of the bladder. When damaged, this muscle cannot squeeze and close off the urethra, the tube that carries urine from the bladder to the outside of the body. The result is urine leakage.
There are three types of incontinence:
- Stress urinary incontinence (SUI): leakage during actions — such as sneezing, coughing, laughing and lifting — that put abdominal pressure on the bladder
- Urge incontinence (also known as overactive bladder [OAB]): An overwhelming need to urinate (gotta go, gotta go!) that may prevent reaching the toilet in time
- Mixed incontinence: symptoms of both urge and stress incontinence
What causes male stress urinary incontinence (SUI)?
The most common cause of SUI in men is prostate cancer treatment. Surgery, radiation or a combination of therapies can affect the external sphincter muscle and its functionality. Almost all men experience SUI immediately after prostate cancer surgery. This is normal and for most patients usually resolves within the first six months of healing.
However, SUI casts a long shadow over daily routines. Simple pleassures like laughing with friends, exercising, or even coughing can become sources of anxiety. The constant need to be near a restroom dictates schedules and limits spontaneity. Travel, social gatherings, and even work can become stressful ordeals.
Untreated SUI can lead to more significant physical health issues. Skin irritation and infections are common due to constant moisture. The persistent dampness can create a breeding ground for bacteria and fungi, leading to painful rashes and sores.
Furthermore, the constant worry about accidents can restrict physical activity, contributing to a sedentary lifestyle and its associated health risks like weight gain, cardiovascular problems, and weakened muscles. The fear of leakage can also discourage proper hydration, leading to dehydration and potential urinary tract infections.
Treatment options for SUI
The good news is that SUI is often treatable. Effective solutions range from simple lifestyle changes and pelvic floor exercises to minimally invasive procedures and medications. Talking to your doctor is the crucial first step. They can help determine the underlying cause of your SUI and recommend the best course of action.
Besides lifestyle modifications, there are other ways to treat SUI. There are two broad categories of treatment methods: coping and long-term treatment options.
- Coping options include absorbent products like pads or diapers; penile clamps; indwelling urinary catheters
- Long-term treatment options include Slings and Artificial urinary sphincters (AUS).
Urethral slings are minimally invasive solutions for mild SUI. It acts as a "hammock," repositioning and supporting the urethra to help restore normal bladder control. While AUS is considered the gold standard treatment for moderate and severe SUI.
It is a three-part urinary control system contained completely in the body. It is filled with saline and uses the fluid to open and close the cuff surrounding the urethra. When you need to urinate, you squeeze and release the pump in the scrotum several times to remove fluid from the cuff. When the cuff is empty, urine can flow out of the bladder.