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Frequently Asked Questions: Male Incontinence

What is incontinence?

Incontinence is the inability to control the passage of urine. A symptom rather than a disease, incontinence can range in severity from an occasional, small amount of urine passing to constant leaking to the complete inability to hold any urine. Some men experience incontinence after prostate surgery (such as radical prostatectomy or transurethral resection of the prostate (TURP)) or urine leakage during physical activity.

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What are urge incontinence and stress incontinence?

Urge incontinence, a major symptom of overactive bladder, occurs when you have a sudden, urgent need to urinate and leakage occurs before you reach a bathroom. Stress incontinence is due to weakened pelvic floor muscles or damage to the urethral sphincter. Stress incontinence is when leakage occurs due to stress such as a cough, sneeze, laugh, or physical activity. Ninety percent of those who have this symptom are women.1

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What causes male incontinence?

Each type of male incontinence has its own causal factors. Stress incontinence can be caused by a variety of factors: prostate surgery damaging the sphincter muscle, being overweight, genetic weaknesses, radiation therapy or other chronic conditions. Urge incontinence (overactive bladder) is caused by damage to the bladder’s nerves, nervous system or muscles. Overflow incontinence is caused by weak bladder muscles, blockage of the urethra, or medical conditions such as tumors. Functional incontinence is caused by mental confusion associated with dementia or arthritis that slows the person’s ability to unbutton or unzip clothing or to get to the bathroom in a timely manner.

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I recently had prostate surgery. Is there help for male stress incontinence associated with prostate surgery?

In general, stress incontinence is an acquired form of incontinence after prostate surgery, most commonly prostate removal for cancer. Most men do not have trouble with incontinence for more than a few weeks or months after prostate surgery. Sometimes the leakage is a result of irritation from the catheter that was in place after surgery. Sometimes it is due to weakness or damage to the sphincter muscle that normally holds in the urine. Most men find that the leakage disappears in four to six months. However, the amount of incontinence after prostate surgery is fairly unpredictable and can vary from person to person. Consult your physician about your particular symptoms after having prostate surgery. Typically, your physician may suggest an exercise regimen to strengthen the muscles in your pelvic area and may also prescribe medication. If neither of these is successful, your physician may consider various procedures such as ProACT, Injectables, male slings or an artificial urinary sphincter. The treatment chosen will depend on your personal situation.

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How does incontinence impact quality of life?

If you are struggling with urinary incontinence, you may experience changes in your behavior, emotions, social relationships, effectiveness in your job, and mental well-being. You may decide to reduce your fluid intake, wear incontinence pants or absorbable pads, switch from high to low impact exercise, or forgo active work or lifting moderate weight.

Emotionally you may feel that you’re no longer yourself, that you’re losing control and that you can no longer do the things you love to do. This can also impact your social activities if you are self conscious or embarrassed about possible odor. You may feel frustrated with your uncooperative body functions and view your treatment options as being limited, particularly if you don’t want surgery. Some people report feeling ashamed and suffer from lowered self esteem due to being incontinent.

It is important that you seek care from a urologist who may be able to provide treatment that will help with your condition and should improve your quality of life.

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What can I expect when I visit my physician to discuss my incontinence?

About 80% of those impacted by urinary incontinence can be cured or improved.1 When you meet with your physician, you will provide your medical history and will be given a thorough examination. Your doctor will ask you many questions like:

  • How long has the leakage been happening?
  • How often does it happen each day?
  • Are you aware of the need to urinate beforehand?
  • How much urine is leaking?
  • Do you wear protective pads or garments? What kind and how often?
  • How much does it impact your daily routine and your life?
  • Is it more difficult to control when you cough, sneeze, strain or laugh?
  • Is it more difficult to control when you are walking, running, or jumping?
  • Are you constipated? And for how long?
  • What medications do you take?
  • Do you smoke, drink coffee or alcohol?
  • Do you have diabetes or is there a family history of it?
  • Do you have any other symptoms?

Diagnostic tests may also be performed:

  • Urinalysis
  • Urine culture to check for an infection
  • Cystoscopy to inspect the inside of the bladder
  • Urodynamic studies to measure pressure and urine flow
  • Uroflow to measure pattern of urine flow
  • Post void residual to measure the amount of urine after urination

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What can I do to better manage my incontinence?

Fortunately, you can take the first steps to manage it by changing some behaviors and by retraining your body with specific exercises. These measures may be helpful:

  • Increase fiber in your diet to avoid being constipated.
  • Quit smoking to reduce coughing and bladder irritation.
  • Avoid alcohol and caffeinated beverages which overstimulate your bladder.
  • Avoid any foods or beverages that irritate your bladder.
  • Closely monitor your blood sugar if you have diabetes.
  • Lose weight if needed.

You can strengthen the muscles of your pelvic floor through bladder retraining or Kegel exercises. You can retrain your bladder by urinating on a schedule, whether you feel the need to go or not. You gradually increase your intervals by 30 minutes until you are only urinating every 3-4 hours without leakage. Kegel exercises require that you contract your pelvic muscles for 10 seconds at a time and then relax them for 10 seconds. You will do this 10 times in one session and repeat each session three times per day. Biofeedback and electrical stimulation can help you learn how to more effectively perform Kegel exercises.3

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What treatment options are available?

Treatment options for men vary according to your type of incontinence and the causes. Treatments can be categorized into three types: behavioral (those noted in the above FAQ), pharmacological, and surgical.

After a physical examination, your physician may recommend medications including drugs for male stress incontinence or other types. These can help control incontinence or the doctor may opt to take you off a drug or medication that may contribute to your symptoms.

View information on ProACT™, a surgical treatment of stress urinary incontinence for men commercially available only outside the United States. Other treatment options include injectable bulking agents, male slings and artificial sphincters.

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Where can I go to do online research on male incontinence?

Several well-respected organizations provide useful and credible information about urinary incontinence. The National Association of Continence is a nonprofit, consumer advocacy organization that offers information about urinary incontinence, incontinence products and services, and can help you identify a physician who specializes in treating urinary incontinence.

If you’d like to connect with others, there are also additional links to other informational sources and online support groups in our Incontinence Resource Center.

For patients outside the United States: Learn more about ProACT™ as a treatment for incontinence after prostatectomy.

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Bibliography

1 National Association for Continence Website. 2004. National Association for Incontinence. Nov 2007.

2 Greenstein M. Medical Encyclopedia; Urinary Incontinence. 23 July 2007. Medline Plus. Nov 2007.

3 Urinary Incontinence & OAB Health Center. 2005-2007. WebMD. Nov 2007.

4 Sobol, J. A New Treatment for Male Stress Incontinence. 29 Aug 2007. IncontinenceNetwork.com. Nov 2007.

—This page last modified Wednesday October 22, 2008