Male Incontinence

    Did you know that 1 in 4 men over 40 years will experience some form of urinary leakage in their lifetime? This is why it’s so important to know what you can do to improve personalised continence care, to help manage, if not reduce or treat, urinary leakage issues to increase the quality of life and confidence of individuals.

    Meet Dr Professor Ian Milsom

    ‘Urinary leakage is common in men, especially later in life, but many men still remain undiagnosed and hence lack the benefits of modern management,’ says Professor Ian Milsom, Director of the Gothenburg Continence Research Center at the Institute of Clinical Science, Gothenburg University. ‘Even today, men refrain from seeking help for urinary leakage, despite the fact that it has widespread human and social implications.’

    We asked Dr Professor Milsom some question to bring you the must know facts, and what you can do to help.

    Causes and types of male incontinence

    There are multiple types and causes of male urine leakage and prevalence increases with age. Below you can read more about the most common types. It’s advisable to recommend a visit to a doctor or health care professional, so individuals can discover the underlying cause of their issues, and the best course of treatment for their needs.

    Urge urinary incontinence

    Urge or urgency incontinence is defined as the involuntary loss of urine associated with a strong desire or urgency to urinate. There are many different factors that cause urgency feelings, for example; urinary tract infection, coffee and energy drinks, bladder stones, constipation, medication (like diuretics) and bladder outlet obstruction which can be caused by an enlarged prostate.

    Drinking too much can lead to the production of large amounts of urine and frequent toilet visits, as too can low fluid intake – as the urine gets too concentrated and irritates the bladder lining. In many cases, the cause of urgency urinary incontinence can´t be defined.

    Stress urinary incontinence

    While stress urinary incontinence (SUI) is the most common type of incontinence in women, it is not so common in men. SUI occurs when the support for the urinary tract and bladder doesn’t function as it should. This means that when pressure is put on the bladder, e.g. during exercise or a sneeze, the pelvic floor muscles can’t support the bladder and functions needed to prevent involuntary urine leakage. In men, SUI is most commonly a side effect of prostate surgery. Other reasons may include, deformities in the urinary tract or neurological causes.

    Other causes and types

    Post micturition dribble

    Some men experience drips and dribbles after visiting the toilet. This happens if there is any urine remaining in the urethra after urinating. It’s often the result of weak pelvic floor muscles.

    Terminal dribble

    Another issue some men may face is terminal dribble. This is when the urine flow slows to a trickle or dribble which is then is usually hard to shut off and finish.

    Neurogenic bladder

    Problems associated with brain function, damage to the spinal cord or nerves can also reduce bladder control.

    This can be caused by conditions like stroke, MS, Parkinson´s disease, diabetes etc.

    Overflow urinary incontinence

    Overflow urinary incontinence occurs when the bladder cannot empty completely and is filled past its capacity. This causes over expansion of the bladder and involuntary urinary leakage. This is usually related to an enlarged prostate and symptoms may include; difficulty in starting to urinate, feeling that the bladder is not emptied after urinating, an interrupted or weak urine stream and a frequent urge to urinate and frequent night time urination.

    As well as urethral obstruction, it can be a result of certain types of medications or nerve damage.

    Peters story

    Male urine leakage is a common issue, with 1 in 4 men over 40 experiencing some form. Peter tells us how it affected him.

    Peter's story about his urine leakage

    What you can do - it's common, find support

    It’s common, so talk about it

    ‘Often men are ashamed of their problem or they are unaware that help is available,’ says Ian Milsom. So, it’s important to reassure men that it’s common and there are treatments and supportive products available to help manage, if not reduce this problem. The best first step is to encourage them to talk to a doctor.

    ‘Let men know that they don’t need to suffer in silence. Help is available. Encourage them to book a visit to their doctor.

    or health care professional who can assess their individual issues and advise them on the most suitable form of treatment,’ says Professor Milsom.

    Find best kind of support

    There are lots of great absorbent products and aids available for men of all ages and level of activity. It’s important to find a product that suits the individual’s needs and lifestyle, so that it can be easily incorporated into a healthy continence routine. This can help ensure that the patient keeps up his confidence.

    What you can do - think healthy, think hydration

    Think healthy

    While a bad diet and inactivity hasn’t been clinically proven to cause incontinence, Professor Milsom explains that there is a strong association between the two.

    ‘It’s important over your entire life to maintain a healthy and sound lifestyle in order to avoid chronic conditions like obesity, respiratory problems such as chronic bronchitis, which can be caused by smoking, and cardiovascular conditions such as a stroke. These are all strongly related to urinary leakage. So, enjoy a healthy diet and exercise regularly.’

    Think about hydration

    It’s important to not cut out fluids altogether but, as Professor Milsom points out, ‘it can be beneficial to think about restricting fluid intake in certain situations’.

    For instance, when managing night time urine leakage, reducing fluid intake just before going to bed can be beneficial, as can be restricting fluid intake before a theatre or concert visit.

    When it comes to caffeine and alcoholic drinks, there is conflicting information on the matter. ‘Some studies indicate that the ingredients in coffee and tea have a direct effect on bladder function and the risk of incontinence, not only via the intake of extra fluids. This has however been disputed in other studies,’ says Professor Milsom.

    While alcoholic beverages can also influence the risk of urinary leakage via the quantity drunk, or excessive amounts of stronger alcoholic drinks effecting brain function, the important thing to think about is, enjoying everything in moderation.

    Train your pelvic floor

    Pelvic floor exercises (Kegel exercises) are an effective way to improve, regain, if not maintain, bladder control for all types of urine leakage and especially for those experiencing stress incontinence post-prostate surgery. Easy and low impact, pelvic floor exercises can be done by everyone, of all ages, lying, sitting or standing. Professor Milsom advises, ‘guidance from a physiotherapist, continence nurse adviser or urologist to help you performing pelvic floor exercises in an optimum fashion.’

    To get started, read more about pelvic floor exercise at TENA Men – exercise your control.

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