Patient Perspective: Roger's Story

 Rogers Story of Living With Overactive Bladder

I see it all the time – the ads for OAB, featuring these women who have to run to the bathroom every five minutes. They’re always women, right? You never see a man in these ads.  But I’m a man, and quite frankly, I feel a little left out.

I have OAB. I’ve lived with this condition for the past several years. I don’t have any known reason for it – I’ve never had prostate issues, am not on many medications, and rarely get bladder infections. But the urge to use the bathroom strikes me often and it’s pretty annoying. I usually make it in time, but have had the occasional leak. I’ve talked with my doctor about it but after he determined that my prostate was normal, he sort of brushed it off for a while – I don’t think he’s used to hearing a man come in with this type of problem unless it’s prostate related. But I finally was persistent enough that he prescribed some medication.

I experienced so many negative side effects from each medication I tried over the course of several months that I stopped them completely. It was then that my doctor finally recommended Botox. Yes, I had Botox injected into my bladder. And I have to say it was one of the best things that happened to me. It took almost no time to work, I didn’t need to use a catheter (I guess some people need to), and it lasted about 6-7 months before I had to go back in for another treatment.

It took some pushing on my part, but I was able to get treatment for my OAB. If you’re a man with this condition, don’t let it control you, and don’t believe there’s not a treatment available for you. The media and drug companies focus on women because it’s more common for them to have these types of issues, but men can have them just as easily.  And the medications and procedures work just as well for us.

Do something about your OAB. I’m so glad I persisted and got treatment for it. It helps me live a fuller life without the worry of overactive bladder.

Roger S., New York, NY

Patient Perspective: Brad's Story

 Brad's Story - Opening Up About Incontinence

My friends and I are close. Growing up in a small town, we’ve always been there for each other – to joke with, lean on in hard times, and to razz each other. We have a tight-knit group of 5 and they’ve been my chosen family since I was 12. It’s hard to believe so much time has passed since our early days, but here we all are.

I experienced incontinence after having my prostate removed in 2013. It wasn’t a fun thing to go through, and I certainly didn’t enjoy it, but the one thing that made it easier was that I knew to expect it – and that I wasn’t the only one.

You see, one of my buddies in our group, Joe, had also gone through something similar a few years back. He pulled me aside before surgery and told me that the worst thing that was going to happen was that I’d probably have some leaks – maybe a lot. It had happened to him for at least a year after his surgery and he said it was “hell “.

But he told me that the thing that had made it worse was not knowing it was coming, That was why he was talking to me – he wanted to me to know that I wasn’t alone. And, if it weren’t for his advice and pick-me-up talks, I don’t know how I would have gotten through that first year.

I’ve recovered well and don’t really experience the leaks anymore. But I still talk about it. Because that’s what we should all do with those we are close to. You never know who might benefit from your experience, or who might also go through something similar and just need a friend or to know they are not alone.

Don’t let your own embarrassment get in the way of opening up to your loved ones. I’m sure glad Joe didn’t.
 
Brad T., Auburn, AL

Patient Perspective: Ethan's Story. Overcoming Adult Bedwetting

 Ethan's Story of Overcoming Adult Bedwetting

I am an adult bed wetter.  Those are hard words to say for a 52 year old man. I first started experiencing nighttime leaks when I was in my teens.  Just once in awhile. I’d laugh it off with my brother.  

But as I grew further into adulthood and it kept happening, I knew it was no longer a laughing matter. I found that the problem worsened when I went away to college and I took great pains to keep it hidden from my roommate.  I dared not buy protection from the stores near my campus for fear of someone seeing me, so I would drive an hour away just to pick up whatever absorbent pads I could find, which usually were not a great fit and didn’t do a lot to protect me.  I put blankets on my bed to absorb the leaks, but they didn’t help mask the odor.  

After college I got my own place, without roommates, so I wouldn’t have to worry so much about them finding out. I finally made the decision to speak to a doctor at age 30 – nearly 14 years after suffering from this problem on and off.  

While I still don’t know the reason I wet the bed, my doctor helped me find resources to manage the condition.  After trying several different absorbent products, I finally found one that fits well and is specific to nighttime use, so I rarely wake up anymore with leaks.  

I’ve also discovered that I’m not the only one out there with this problem – NAFC’s message boards have really helped me connect with others and sharing with them has been such a relief.  After years of embarrassment and isolation, I’m so thankful to have found help and to know that I’m not alone.

Ethan S., San Jose, CA

Patient Perspective: Larry's Story

 Larry's Story - Learning to manage my incontinence

I’m 68 years old and I have incontinence. I’ve suffered a lot of setbacks over the years. I lost a finger in the army. I suffer from high blood pressure. And I have an old football injury that flares up regularly. But I have never suffered as much shame and humiliation as I have since I started experiencing incontinence.

It started innocently enough - a leak here and there. My doctor said it was due to prostate problems and gave me some medication to help. It did for a while, but then the leaks flared up again and I was forced to admit that this problem was not going away.

My first trip to the grocery store to purchase incontinence pads was a doozy. Standing there, looking at the wall of options was so intimidating. What do I choose? What size? How do I know it will fit? What if it doesn’t – can I return the bag? I had so many questions and no one to ask – after all, it’s not like men just talk about peeing their pants with each other all the time. Not to mention I kept looking over my shoulder to make sure that no one I knew saw me standing there. It would be so embarrassing to be “caught” in this situation.

When I finally got home, I started trying out the various absorbent products that I had purchased. I had bought 3 different types and gave each one a fair shot for a full day before making the call. Unfortunately none of them worked so I was back to the drawing board.

Fortunately, my wife found a company online that sold different products so I gave it a shot. I don’t know why I didn’t start with this option in the first place. They offered a free consultation so I gave them a call. The rep was so helpful and it was great having a guide to walk me through the different options, and also learn more about me, my condition and my lifestyle to help find something that would work best for me.

These days, I only use online services to order absorbent products. And, I’ve found great products that help me keep my leaks controlled, and my condition under wraps so no one is the wiser.

I still don’t love having incontinence, but it’s become such a normal part of life now that it doesn’t have the same hold on me as it once did. I didn’t envision this happening to me, but am happy to know that there are resources out there to help and products available that can make it more manageable. I feel free to live my life without fear of leaks and that is something to be really proud of.

Larry B., Seattle, WA

Patient Perspective: Nick's Story

 Nick's Story - Incontinence After Prostate Removal

In August of 2015, I underwent surgery to have my prostate removed.  I had been diagnosed with prostate cancer the year before and my doctor had been closely observing me since then. 

When it seemed that my cancer was growing more quickly than he liked, he suggested surgery.  “Afterall”, he said, “you’re only 63.  You can still have a long life without worrying about this.”

So, after a lot of research, I went for it.  I knew there would be complications afterward, but incontinence was not something that I had anticipated being that big of a deal.  I thought I’d probably have to wear diapers for a couple of weeks and that would be the end of it. 

Boy was I wrong. 

Nine months later and I was still having a difficult time making it to the restroom.  It was so embarrassing as a man to face this problem. I couldn’t do the things I wanted to because I was scared of having an accident or a leak, and I felt ashamed of the bulky diapers that I was forced to constantly wear. 

I finally made an appointment with a surgeon in May to discuss a sling procedure and will be having the procedure done next month.  I’m hopeful that this will be a solution for me so that I can get on with my life and get back to doing the things that are important to me. 

Nick W., Houston, TX

Patient Perspective: Samuel's Story

 Samuel's Story - Getting Help For Incontinence, Enlarged Prostate

How many of you men have incontinence? How many of you would admit if you did?  It’s a hard thing to come to terms with as a man. I know, because I’m one of the "lucky ones" who has been hit with this condition.

I had been noticing the need to use the bathroom more frequently for a while, but didn’t think much of it until I was on vacation with my wife a few years ago. We were in DC, walking around, being the typical tourists, when I suddenly felt the need to go. I wasn’t totally familiar with the area, and it was crowded, so it took me a while to find a bathroom. Unfortunately, it took me too long. I leaked – just a little bit, but enough to be able to tell. Luckily, I had a sweatshirt with me so I just wrapped it around my waist and told my wife we needed to head back to the hotel.

I was so embarrassed. She didn’t understand what had happened until we got back and saw that I needed to change my pants. And even then, it was hard for either of us to comprehend what had happened – I’m a grown man! I shouldn’t be wetting myself. We both brushed it off as a fluke and went on with the rest of our trip.

But a few weeks later at the gym, it happened again. And then again while doing some yard work at home. I started to feel like my body was betraying me. Why was this happening? I didn’t tell my wife that the problem had persisted until a few months later, when it was clear that I would need to get some help. She was so understanding and helpful. She did some research online to see what may be causing it and the treatment options available, helped me find a urologist to talk to, and even came with me to my appointment.

I’m happy to say that after talking to the doctor and getting treatment, I’m doing much better. Turns out I had an enlarged prostate so I’m on medication for that and it’s greatly reduced the need to run to the bathroom every five minutes, not to mention the leaks.

This has been a very humbling experience, but I’m glad that I opened up to my wife about it and that she was so understanding and helpful. I’m not sure I would have had the strength to get to a doctor about this had it not been for her pushing me along. Now, I’m leak free and am able to travel, workout and do pretty much what I want again without having to worry.

Samuel M., Cheyenne, WY

Ask The Expert: Should Men Do Kegels?

 Should Men Do Kegels?

Question: I hear about kegels for women all the time, but what about men? Can kegels benefit men too?

Expert Answer: Absolutely!  Kegels are an important part of a woman’s workout routine to prevent or manage bladder leaks, but they are just as important for men. In men, kegels can help with fecal incontinence, overactive bladder, urinary retention, erectile functioning and even orgasms.  Interested in seeing the benefits for yourself? Here’s how to do them:

How To Do Kegels For Men

There are two types of kegel exercises that you can do to strengthen and tone your pelvic floor muscles.

Long Contractions.  

Long Contractions work on the supportive strength of the muscles. To perform a long kegel contraction, tighten your pelvic muscles and hold for 5 seconds. This may be difficult at first – don’t worry if you can’t hold the contraction for the full five seconds. With practice you’ll be able to work up to this.

Overtime, work your way up to 10 seconds per contraction. Be sure to rest for 10 seconds in between each contraction – knowing how to relax your muscle is as important as the contraction.

Short Contractions.  

Short contractions work the fast twitch muscles that work quickly to stop the flow of urine and prevent leaks. To perform a short contraction, tighten your muscles quickly, then release, and repeat.

When Should I Perform Them?

Like any muscle, you don’t want to do too much too soon. Aim for 5 reps of both short and long contractions, 3x per day on your first day. As you gain more confidence and strength, work your way up to 10 reps, 3x per day of each.

Continue practicing kegels and you should see improvements in 3-6 months. And, if you find that you need some help with kegels, talk to your doctor or physical therapist. They will be able to provide you with more personal instruction, which may include biofeedback therapy.

Good luck!

Ask The Expert: How Do I Talk With My Husband About His Incontinence?

 How Do I Talk With My Husband About His Incontinence

Question:  My husband of 47 years has recently started experiencing incontinent episodes. He’s a very proud man and doesn’t want to admit them to me, but it’s starting to become a problem due to the increased laundry, smell and his overall depressed attitude about it. How can I get him to open up and talk with me about it?

 

Answer:  This is a common problem in marriages, especially pertaining to men. Most men don’t want to admit they have a problem with bladder control. They feel ashamed, and hate the idea of wearing protection. He may never come out and admit it to you on his own, so here are some tips to broach the subject with him:

1. Make him feel comfortable.

As you’ve already figured out, incontinence is a very uncomfortable subject for your husband. Make him feel at ease and approach him about his bladder leakage in a way that is not threatening or accusatory. Find some neutral territory and talk to him at a time when he feels good. Don’t try to broach this subject right after he’s had an accident.  That will only make him feel more embarrassed and ashamed.

2. Show him that you are understanding and want to help him with his bladder leakage.

Before you talk with him, do a little research on incontinence and learn what may be causing the issue. Did he just have prostate surgery? Is there something else that has changed recently that could be contributing to his accidents? Read about the causes, and the many different treatment options and management strategies for bladder leakage. Show him that there are ways to manage the condition and that he doesn’t have to just live with it. Let him know that you care about him and want to help. Show him that you are a team so that he doesn’t feel so alone.

3. Encourage him to seek treatment for his incontinence.

Incontinence can often be a symptom of an underlying condition. Let your husband know that you want him to talk with a doctor to make sure that there is nothing serious going on, and to help him get the problem under control. He may be resistant to speaking with his doctor, but press on (slowly). The sooner he confronts his incontinence with a professional, the sooner he can begin treatment and start feeling like himself again. (Find a specialist in your area with our Specialist Locator.)

4. Be his advocate for care.

Because your husband is so embarrassed about his incontinence, you may need to be his voice when seeking out treatment options. Help him research incontinence so that you both can learn more about it. Write out questions that he can bring with him to the doctors office to ensure he doesn’t forget anything important. Be sure to voice any concerns over treatment options. And help him stay the course on his path to treatment.

5. Introduce him to the NAFC message boards.

The NAFC message boards are a great place for your husband to explore and ask questions – anonymously! There are many people on the boards who may be experiencing the same things he is who he can talk to. Plus, with so many people dealing with incontinence in the same spot, there are lots of learnings and tips he may be able to pull from to help his own situation. (As an aside, the message boards may also be a great spot for you to do some research too.  Talk with other caregivers to get some ideas. Or ask other men living with incontinence how you might be able to best approach your husband about the topic.)

It’s never easy talking about incontinence to a loved one – especially men. But by being a caring and supportive spouse, you’ll show your husband that you are in his corner, and that you are there to help. Good luck!

It's Bladder Health Awareness Month, 2017!

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Hello Readers!

Each year, NAFC, along with several other health organizations, celebrates Bladder Health Awareness Month by raising awareness of the many conditions that can affect the bladder and how to treat it. This is an important month for NAFC – while we touch many people each day, it’s estimated that over 25 million Americans live with incontinence. And many of those people wait years before even having a conversation with their doctor about treatment options. It’s a debilitating condition that can cause shame, embarrassment, isolation and depression for those it touches, and, unfortunately, it is widely (and incorrectly) thought to be a condition that people should just accept as they get older. This couldn’t be further from the truth and this month, it’s our chance to shine the spotlight on the condition and show people that living with incontinence is no way to live.

So, what can you expect this month from NAFC? A lot!

Here’s a rundown of how we’re doing our part to stop the stigma:

Life Without Leaks Awareness Campaign.

NAFC launched the Life Without Leaks Campaign earlier in 2017 and it’s still going strong! Designed to show men and women of all ages that they don’t have to live with bladder leaks, this campaign sheds light on the effects of incontinence and shows people that by not treating their incontinence, they may be missing out on the best parts of their life. Life is possible without leaks. Check out the campaign here.

Blog Series: The Lifecycle of Incontinence.

This series will break down the stages of incontinence, from learning to accept you have the condition, to a description of the many treatment options available to you. Follow along on the BHealth Blog each week as we discuss the following topics:

  • Week 1: Learning To Accept You Have Incontinence
  • Week 2: What You Can Do To Manage Your Condition Before You See Your Doctor.
  • Week 3: How To Talk To Your Doctor About Incontinence
  • Week 4: Your Guide To Treatment Options.

BE STRONG Classes. 

Our BE STRONG classes are designed to show you the many benefits of maintaining a strong and healthy pelvic floor. All of our classes are taught by Pelvic Floor Specialists and are a great way for you to learn more about this vital group of muscles. Find one in your area!

How You Can Get Involved

Follow Us On Facebook and Twitter – and help us raise awareness! 

Not only will you be able to follow along with everything that’s happening this month, you can help us raise awareness by liking and sharing our posts. Better yet – post our Bladder Health Facts to your own pages! Be sure to tag us with the hashtags #LifeWithoutLeaks and #BHealth!

Make A Donation To NAFC. 

We love doing what we do. And we make a pretty big impact, reaching over 1,000,000 people each year who need our help.

But we can’t do it alone.

Support from our readers is the only way we’re able to continue offering the education and community we’ve created on nafc.org. It’s how we’re able to continue creating free courses for your local communities. It’s how we’re able to advocate for patients in home and at assisted care facilities for quality incontinence supplies. It’s how we provide thousands of free educational brochures to patients looking for help. And it’s how we are able to increase the awareness of the impact of incontinence on those it touches. Donate today to help us ensure everyone has access to these free materials, and can learn how to live a #LifeWithoutLeaks.

Start A Fundraiser On Facebook! 

We know sometimes it’s hard to give. But if you’re passionate about our cause and want to help, consider setting up a fundraiser for us on Facebook. It’s super easy to do and all the funds come straight to NAFC. Read our step-by-step instructions on how to do it here.  With #GivingTuesday coming up on the 28th of this month, it’s a great time to get this going.

So there you have it!  We hope you’ll follow along with us this month to learn more about incontinence and help support us throughout the month to increase awareness of Bladder Health! 

Sincerely,

The National Association For Continence

Men And Kegels - The Ultimate Guide

 Men's Ultimate Guide To Kegels

Kegel exercises have long been associated with women – something that they do during pregnancy and post childbirth to tone up their pelvic floors and prevent or ease incontinence symptoms. But Men, if you haven’t tried kegels, you’re truly missing out. Not only can they help ease bladder leakage if you have it, experts claim that they can also give you a stronger erection and orgasm. Want to learn more? Keep reading.

What are Kegels and what muscles do they work?

Kegels are basically the contracting of the muscles in your pelvic floor. Your pelvic floor is comprised of a tightly woven web of muscles, located in the base of the pelvis between the pubic bone and tailbone. These muscles have three main functions:

  1. They help support the pelvic organs such as the bladder, the intestines and the rectum.
  2. They help control bladder and bowel function and can prevent or ease symptoms of bladder leakage.
  3. They are involved in sexual functionality.

As with any other muscle in the body, if they get weak, they can no longer perform their job. These muscles can naturally stretch and become weaker over time, but with proper exercise they can remain strong to ensure good sexual and bladder health and function.

How do kegels benefit me? 

Kegels can address a number of issues that men may face related to their bladder or bowel.

Bladder Leaks. 

Urinary incontinence is a condition that affects as many as 15% of men aged 15-64, and may be caused by a number of health conditions. The most common cause of incontinence in men is due to problems with the prostate, but other conditions can affect bladder function as well. Incontinence in men can range from a small amount of leakage after urination, or more substantial leaking when performing physical activity or placing stress on the bladder (laughing, coughing, working out, lifting heavy items).  A Kegel regimen can help to tone these muscles to prevent the leaks from happening.

Fecal Incontinence.

As with urinary incontinence, weakening of the pelvic floor muscles can also affect the anus and rectum, resulting in loss of bowel control. But, kegel exercises can help to tone and strengthen this area up as well to prevent bowel leakage.

Overactive Bladder.

You’ve probably seen a million pharmaceutical commercials for what’s known as Overactive Bladder – the urgent and frequent need to empty your bladder. When you have an overactive bladder, the muscles of the bladder contract involuntarily, creating an urgent need to urinate. Performing kegels can help improve control of these muscles, improving, or even eliminating the chance bladder leakage.

Urinary Retention.

Ever had difficulty starting a stream of urine? How about a weak flow, and the feeling that you need to urinate again right after you’ve finished? It could be urinary retention, which is usually caused by a blockage in the urinary tract, or nerve problems that interfere with signals between the brain and the bladder.  Bladder retraining is one method that can be used to help fix this, but kegels can also help the nerves and muscles used in emptying the bladder to work better.

Erectile Functioning.

Erectile Dysfunction, or ED, can be caused by many physical conditions (heart disease, diabetes), or can be the result of surgery (like prostate removal) or trauma. The good news is that you don’t have to resort to medications to treat it – kegel exercises can help strengthen your muscles in your pelvic region and regain normal function. In men, kegels specifically help strengthen the bulbocavernous muscle.  This is the muscle that is responsible for erections, contractions during orgasm and ejaculation, and emptying the urethra after urination. Studies have found that regular practice of kegels can keep this muscle strong, and if you’re experiencing problems, kegels may improve your symptoms.

Ejaculation & Orgasm. 

Again, this goes back to the bulbocavernous muscle – the stronger the muscle, the stronger the contractions you’ll have during orgasm. Enough said.

How do I do a kegel?

First, you need to locate the right muscles, which is often the hardest part. The next time you’re urinating, try stopping the flow mid-stream. If you can do that, you’ve found the right muscle. (But don’t do this on a regular basis – this should only be done when trying to locate the correct muscles.)

There are two types of kegel exercises that you can do to strengthen and tone your pelvic floor muscles.

Long Contractions.  Long Contractions work on the supportive strength of the muscles. To perform a long kegel contraction, tighten your pelvic muscles and hold for 5 seconds. This may be difficult at first – don’t worry if you can’t hold the contraction for the full five seconds. With practice you’ll be able to work up to this.

Overtime, work your way up to 10 seconds per contraction. Be sure to rest for 10 seconds in between each contraction – knowing how to relax your muscle is as important as the contraction.

Short Contractions.  Short contractions work the fast twitch muscles that work quickly to stop the flow of urine and prevent leaks. To perform a short contraction, tighten your muscles quickly, then release, and repeat.

When should I perform them?

Like any muscle, you don’t want to do too much too soon. Aim for 5 reps of both short and long contractions, 3x per day on your first day. As you gain more confidence and strength, work your way up to 10 reps, 3x per day of each.

It may take time to see changes, but consistency is key here. Continue practicing kegels and you should see improvements in 3-6 months. And, if you find that you need some help with kegels, talk to your doctor or physical therapist. They will be able to provide you with more personal instruction, which may include biofeedback therapy.

Men, Here Are 5 Reasons You May Be Experiencing Bladder Leaks.

men bladder leaks

Women sometimes get all the attention when talking about bladder problems. And while it’s true that bladder leakage affects more women than men, that doesn’t mean men are free from the condition. In fact, studies suggest that as many as 15% of men living at home between the ages of 15 to 64 are affected by incontinence. 

Here are 5 of the top reasons men may experience bladder leakage.

1. You Have A Prostate Problem. 

By far, conditions affecting the prostate account for the majority of problems in men with incontinence. Enlarged prostate (Benign Prostate Hyperplasia, or BPH) can constrict or block the urethra, compromising the bladder’s ability to effectively empty. This can cause urgency and frequency since the bladder still signals that it needs emptying. And, for men who have had prostate removal surgery due to prostate cancer, urine leakage is common during the first six weeks after surgery. After that, roughly 20% of men may continue to have a significant problem with leakage, or stress urinary incontinence.

2. You’re Overweight.  

Excess weight can place extra pressure on the bladder, which, combined with loss of muscle control, can lead to leakage. If you’re overweight and experiencing bladder leaks, try losing a few pounds – even a small amount can make a big difference. And your overall health will benefit too.

3. You Have Diabetes (or another neurological condition).

happens when there is a lack of bladder control due to a brain, spinal cord or nerve problem. This can be caused by a number of conditions, such as diabetes, MS, Parkinson’s disease, or spinal cord injury. Treatment options vary depending on your symptoms, but they do exist and should be seen to.

4. An Obstruction In Your Urinary Tract.

Again, this is most often caused by an enlarged prostate in men, but can also be due to a blood clots, tumors, bladder stones, or even scarring of the urethra caused by injury or surgery.  Blockage can cause urine to build up, leading to trouble urinating, leakage, and even distended bladder.

5. What You’re Consuming.

While what you eat or drink may not directly cause bladder leaks, if you’re already to prone to them, certain things you consume can make your symptoms worse. Excessive alcohol, certain medications, and caffeine all act as diuretics and can cause you to need to use the restroom more often. Other foods, like citrus foods, artificial sweeteners, and citrus foods can irritate the bladder, causing an increase need to go to the bathroom. This, combined with an existing bladder problem can lead to more leaks.

Men can sometimes have a difficult time speaking up about bladder issues, even to their doctor. And initial treatment options, such as using adult absorbent products, can seem foreign and uncomfortable.  But living with incontinence is no way to live, especially with so many treatment options available to you. If you struggle with #bladderleakage, learn more about your condition, and talk to your doctor about the options that exist for you so that you can continue to live the life you want.

Need help finding a physician who treats incontinence? Use our Doctor Finder Tool!

Your Guide To The New Prostate Screening Guidelines

Prostate Cancer Screening Guidelines

The new guidelines on prostate cancer screening have left some men wondering what they should do. Here’s a quick breakdown on what the US Preventative Services Task Force recommends.

Prostate cancer is the 3rd leading cause of cancer death in men in the US, with about 1 in seven men being diagnosed in their lifetime.   You may have recently heard the news that, despite previous cautions against getting screened for prostate cancer, new recommendations from the US Preventative Services Task Force are now recommending that men ages 55 to 69 at least have a discussion about prostate-specific antigen (PSA)-based screening, including the risks that go along with it.  So, what’s the deal? Will the test help or hurt you?

It depends. Back in 2012, the USPSTF recommended no routine screening at any age, because of the potential harm that could result after testing, including:

  • False Positives: A fair amount of PSA testing has suggested that prostate cancer may be present when there is in fact no cancer. Elevated PSA levels can be caused by many other things that don’t have anything to do with cancer. This can lead to worry and anxiety, and follow up tests that may not be needed.
  • Risk of infection with additional tests. In order to dig deeper after a PSA test, follow-up tests are done, which can potentially cause complications (fever, infection, bleeding, urinary problems, and pain).
  • Even if prostate cancer is diagnosed correctly, it sometimes never causes a problem for men. However, it’s difficult to tell what cancers will, or won’t be an issue later on, so most of the time, aggressive treatment is performed.
  • Treatment for prostate cancer can lead to other side effects, including erectile dysfunction, or urinary or fecal incontinence.

Due to these potential risks, the USPSTF recommended against screening men, since the benefits of screening really didn’t really outweigh the expected harm that could result. What has changed? 

The US Preventative Services Task Force now recommends that men ages 55 to 69 years of age should talk with their doctor about the potential benefits and harms of PSA screening for prostate cancer, and should make individualized decisions on how to proceed. This decision was made after determining that the potential benefits and harms of PSA tests are closely balanced in men ages 55 to 69. However, men over 70 are still recommended to not receive PSA screening.

Really, what all this boils down to is you. No longer should you just ignore the test if you are within the 55-69 age range. After all – it has been shown that of 1,000 men screened, testing may prevent up to 1 to 2 deaths from prostate cancer and up to 3 cases of metastatic prostate cancer over the course of 13 years.

But, you should weigh your options. Have an open dialogue with your doctor about your specific risks – your background and health history, your lifestyle, your healthcare beliefs and wishes – these are all important factors to take into consideration when deciding if and when to get tested.

You should also talk with your doctor about what the course of action would be if your PSA levels do turn out to be on the high side. While this could be a sign of cancer, it may also be caused by something else, such as enlarged prostate, which can be treated.

In the end, the Task Force is really just recommending a discussion. Which is something you should be having with your doctor anyway. Talk with your doctor about the risks so that together you can make an educated decision about your options.

Ask The Expert: Are There Other Things Besides Prostate Trouble That Can Cause Incontinence In Men?

 Prostate Trouble and Incontinence

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: Are There Other Things Besides Prostate Trouble That Can Cause Incontinence In Men?

AnswerProstate problems in men typically get the blame for incontinence issues for good reason – many men experience issues with their prostate (BPH, prostate cancer) which can often cause incontinence, even if it’s just for a brief time. But there are other conditions that may be contributing to the root of the issue as well. Being overweight can put extra pressure on the bladder, which may cause leaks. Certain foods can also irritate the bladder, causing incontinence – especially if you’re already prone to the condition.  Additionally, neurological conditions, such as Parkinson’s or diabetes can lead to neurogenic bladder, where the brain is unable to communicate properly with the bladder. Even still, urinary tract infections or blockages can lead to bladder troubles.

The most important thing to consider is that incontinence is generally a symptom of something else, and can almost always be treated. If you’re experiencing bladder leaks, see your doctor today and ask for help. Your doctor will be able to dig deeper to find the root cause of your incontinence and work with you to find a solution.   

Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Have a question you'd like answered? Contact us!

Men: Let's Talk About Bladder Leakage

 Bladder Leakage And Men

You don’t really hear much about incontinence in men. Let’s face it – it’s not something that anyone ever really wants to talk about, but for men, it can be especially hard. Men are supposed to be tough. Caretakers. Leaders. Defenders. Admitting to something like incontinence can feel like a slap in the face. But it’s something that happens to everyone – not just women – and it isn’t something that anyone should have to live with. 

Unfortunately though, many do. As many as 15% of men living at home between the ages of 15-64 may have some type of incontinence.  

Men – if you struggle with bladder leakage, we urge you to speak up about it. This doesn’t mean shouting about it from the rooftops. But a frank discussion with your doctor or a loved one is a good start.

Here are 4 good reasons to talk to Someone about your incontinence:

You’ll get some emotional support.

Have you ever had something on your mind that weighed on you? Keeping your incontinence a secret can have big effects on your emotional well-being. Many people who live with incontinence become more reclusive as time goes on and the condition worsens. They avoid social activities, or don’t do the things they once enjoyed because they’re scared of having an embarrassing accident in public. But this can mean isolating themselves from others, and hurting some of their close relationships. 

Lean in to those close to you and let them know what’s going on. You’ll likely find that their support motivates you to take the next step in talking to your doctor, where you can finally find some treatment.  Still not ready to talk to someone close? Try our message boards. They're filled with lots of people who struggle with bladder leakage and can be a great resource when you need some tips on how to manage, thoughts on treatment options, or even when you just need a place to vent. Trust us, they know what you’re going through, and are a wonderful and caring community where you can share your concerns without judgment.

You can find out what’s actually causing Your bladder leaks.

In most cases, incontinence is not the real condition – it’s a symptom of something else.  Talking to a professional about it may help you uncover the true source of what’s going on, which could be something that’s easily treated, or something that’s far more serious than some light bladder leakage. Either way, finding out is better than living in the dark, and will help you get the treatment you need to be on your way to recovery.

You’ll learn about the incontinence treatments options available to you.

We’ve come a long way from adult diapers being the only treatment option. While absorbent products are still great management tools, there are many things you can do to actually treat the symptoms and avoid leaks all together. Diet and exercise changes, kegels (yes - they're good for men too!), medications, minimally invasive procedures, and even surgical options all exist. Learning more about your options will help you find something that works for you and your lifestyle, and can feel very empowering.

There’s no good reason not to discuss it.

With so many treatment options available to you these days, there’s really not a reason to stay silent. Yes, it will probably be an uncomfortable discussion at first, but it’s not one that your doctor hasn’t had before.  They hear from men who have this problem all the time. Talk with them and begin getting treatment so that you can get back to the activities you once enjoyed, instead of worrying about your bladder.

NAFC has some great resources that can help you as you begin getting treatment. Check them out below:

NAFC Bladder Diary

Talking about Incontinence

OAB Resource Center

Bedwetting Guide

Gender Neutral Pelvic Floor Tips

 Gender Neutral Pelvic Floor Tips

Simply stated - the pelvic floor isn’t just a female thing - it is a muscular sling supporting the pelvic and abdominal organs of men and women.  The pelvic floor helps keep us dry.  According to an earlier blog post, more than 50 percent of men over the age of 60 experience bladder control issues due to an enlarged prostate.  

Before I share my best pelvic floor tips for both sexes, we need to agree on the following three truths: strengthening a weak pelvic floor may improve bladder control and confidence, utilizing my tips in conjunction with seeing your healthcare provider will create the most optimal effect, and it’s important to allow yourself to have a bad day here and there.  

Here are my best pelvic floor tips.

Start a Bladder or Bowel Diary

For a week, keep track of your trips to the bathroom, your leaks and how much and what you are drinking. Note any trends with fluid intake, time of day and activity level in relation to using the bathroom and your leaks. Your documentation may help your health care provider order tests, make a more accurate diagnosis or prompt a referral to a specialist.But, please consider what you can do with the information. Are there any trends you are seeing? Do you have more problems in the morning, afternoon or evening? Do you need to space out your fluid intake?  ou may be able to cue into changes that may positively impact your bladder control and confidence.  

Drink more water and consider cutting down on alcohol and caffeine

Many newly incontinent persons incorrectly assume if there is less water in the system there will be less water to pass. Cutting out water, or significantly decreasing water consumption, while continuing to consume alcohol and caffeine at normal previous levels may aggravate the bladder and make the leakage problems worse.  Hydration with plain, old water is one of the keys to improved bladder function.  And, revisit your diary – it may be possible that alcohol or caffeine may be a trigger to your leakage pattern.  Do you need notice you have more problems with bladder control after a glass or two of coffee or your favorite cocktail?  

Kegels

Yes – we need to talk about this.  Men can do Kegels and should do Kegels to improve bladder control.  Kegels are not just meant for women.  Repetitively performing Kegels will improve pelvic floor muscle function, strength and endurance.  Kegels should be a habit like brushing your teeth. The truth of the matter is - if your pelvic floor muscles are in better space they will be better able to support you and keep you dry.  Here are some cues that may help you or your loved one perform a Kegel.   

 Return to the idea that pelvic floor is a muscular sling.  It supports your abdominal and pelvic organs kind of like a hammock running along the base of pelvis – front to back and side to side.

  • Gently pull the pelvic floor up and in towards your navel as if trying to protect yourself from a blow to the belly.  When you do this – you may feel a gentle tightening of the muscles underneath your navel.  Your tailbone may gently rises up and in.  Continue your normal breath.  Keep in mind, the Kegel, I am recommending is not 100% effort but a gentle tightening of the muscular sling.
  • Continue breathing and hold the Kegel for a few seconds.  Then gradually relax.  Repeat until you’re fatigued or have completed your goal.

That concludes my list of my best pelvic floor tips. What are your best practices?

About the Author, Michelle Herbst:   I am a wife and mother with a passion of helping women live to their fullest potential.  I am a women’s health physical therapist and for nearly decade have helped women with musculoskeletal conditions during their pregnancies, postpartum period and into their golden years.
About the Author, Michelle Herbst:   I am a wife and mother with a passion of helping women live to their fullest potential.  I am a women’s health physical therapist and for nearly decade have helped women with musculoskeletal conditions during their pregnancies, postpartum period and into their golden years.

Incontinence During Sex - It Happens To Men Too

 Incontinence During Sex Happens To Men Too

Prostate cancer is one of the most common types of cancer in men. According to the American Cancer Society, 1 in 7 men will get prostate cancer in their lifetime (only skin cancer has a higher rate).  And, while many men will go on to survive prostate cancer, the side effects of treatment can be difficult to deal with for many.

A common treatment for prostate cancer is a radical prostatectomy, or the complete removal of the prostate.  This is generally considered a good approach especially if the cancer is contained within the prostate gland and has not spread.  However, one side effect of this procedure is often incontinence.

Stress urinary incontinence, the type of incontinence that happens when you place pressure on the bladder, is common for men who have had their prostate removed or are undergoing other treatments for prostate cancer.  Treatment can sometimes weaken the bladder muscles, causing leakage when a man sneezes, coughs, exercises, or even during sex.  This can be extremely embarrassing for men, and can be discouraging when going through the healing process of having a prostatectomy. The good news is that many men regain full control of their bladder with time after a prostatectomy.

here are 4 tips that may help you avoid some awkward situations in the bedroom:

  • Try to watch your fluid intake in the hours leading up to sex.

  • Avoid consuming bladder irritating food and drinks, such as caffeine, chocolate, or alcohol.

  • Prior to sex, completely empty your bladder.

  • Keep a thick towel nearby in case of any accidents

While this problem can be an embarrassing one, keep in mind that many men deal with this in the months after prostate cancer treatment and with time, this condition should improve.  If you still experience problems a few months after your treatment, talk to your urologist about treatments for incontinence.  He or she can help you navigate the many options available to you and find one that fits best with your needs.

The Importance Of Being Social

 The Importance Of Being Social

When most people think of incontinence, they usually think of the physical problems that go along with it. However, in addition to leakage, there are also emotional and psychological issues that can be just as impactful. Emotional symptoms of incontinence may include the following:

  1. Feeling humiliated and degraded.
  2. Experiencing a poor self-esteem.
  3. Withdrawing from society and becoming more isolated.
  4. Feeling anxious about being incontinent in public.
  5. Reduced intimacy and affection.

But just because you have incontinence doesn’t mean that you should limit your social life.

In fact, being social may help you avoid many of the above symptoms.

Social connections not only give pleasure and enjoyment but they also have been shown to improve the health of individuals. Studies have shown that individuals who have healthy and affectionate relationships with their family and friends benefit in a host of different ways, such as getting fewer colds, avoiding depression, keeping a sharp mind, and living a longer life. 

Don’t believe us? Check out this list of ways that being social can improve your health and mood. And then get out there and start reconnecting with friends and family. Trust us - you, and your health, will thank us.

Prostate Cancer: The Case For Watchful Waiting

 Prostate Cancer; The Case For Watchful Waiting

Prostate cancer is one of the leading cancer causes of death in men in the US.  The American Cancer Society estimates that approximately 1 in 7 men will be diagnosed with prostate cancer in his lifetime.  But, while this is a widespread condition, and treatment is sometimes warranted, the medical industry has begun to see a shift in the prostate cancer treatment, choosing to actively monitor patients over time instead of choosing to perform surgery or conduct radiation immediately.  This treatment path is called “watchful waiting”, and is becoming more and more common for men with prostate cancer.

To understand why watchful waiting is becoming a more popular trend, let’s back up a bit and explain a little more about the diagnosis of prostate cancer.  The average age of men diagnosed with prostate cancer is 66 years old.  Common treatment options for prostate cancer have included medication, surgery to remove the prostate, chemotherapy, radiation, and even hormone therapy.  And while these treatments have become more and more effective over the years, they cause unwanted side effects (such as incontinence and impotence) and pose serious risks (like blood clots in the legs and lungs, heart attack, pneumonia, and infections.)

There has been much debate around whether or not the benefits of treatment outweigh the added side effects and risks that are introduced when one undergoes these types of therapies.  Additionally, it is not clear if these treatment options will completely eliminate the cancer.  For those patients who are low risk, the benefit of aggressive treatment compared to the potential side effects may just not be worth it. 

What types of patients may be good candidates for watchful waiting?  Those who are not seeing any symptoms from the cancer, those whose cancer is small, and located only in the prostate, and those whose cancer is expected to grow slowly all may benefit from this type of treatment. 

Additionally, older men who have a life expectancy of less than 10 years may not benefit from the added years that surgery can offer, making them a better candidate for watchful waiting. 

However, if the cancer is growing steadily, or spreading beyond the prostate, more aggressive treatment is usually recommended.  Men who are diagnosed young may also benefit from more aggressive treatment, as there is a greater chance that the cancer may grow worse over a longer span of time.

Whatever stage you are at, only you and your doctor can decide what is best for you.  Be sure to talk with him or her about the risks and benefits associated with each treatment path prior to making a final decision. 

Ask The Expert: Surgery For BPH?

 Ask The Expert: Surgery For BPH?

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: What types of surgery options are available for BPH?

Answer: BPH, or Benign Prostatic Hyperplasia, is when a man’s prostate is enlarged.  BPH is a common occurrence in aging men, but may not always require surgery.  Surgery may be considered if you have certain issues (you can’t urinate, have seen blood in your urine, have a partial blockage in your urethra, or have kidney damage), or if your symptoms are so bothersome that surgery makes sense to you.

The typical surgical option that is usually used is transurethral surgery of the prostate.  This is where surgical instruments are passed through the opening in the penis to the prostate. Transurethral resection of the prostate (TURP) is the most common type of transurethral surgery used for BPH. This is when a portion of the prostate is removed.  Other methods of removing some of the prostate include laser therapies, transurethral microwave therapy (TUMT), or transurethral needle ablation (TUNA).  Transurethral incision of the prostate (TUIP) is also sometimes used, which places incisions on the prostate which help to relax the opening to the bladder and allow urine to flow from the bladder more freely.

If you are considering surgery for BPH, talk with your doctor about these options and decide together which one may be the best for you.

The NAFC Expert Panel is made up of some of the top medical professionals in the fields of urology, urogynecology, physical therapy, and surgery. Each month, the experts weigh in on important topics and answers to your questions.  To have one of your questions featured in our Ask an Expert series, send it to us here.

Pelvic Floor Exercises Specifically For Men

 Pelvic Floor Exercises Specifically For Men

Pelvic Floor Exercises Specifically For Men

A guest blog written by Michelle Herbst, PT

As a physical therapist specializing in pelvic floor rehabilitation we are referred to as women’s health physical therapists. But, this a little of a misnomer as men have pelvic floors and can have concerns too. In my experience, men participating in pelvic floor rehabilitation make the best patients. They are engaged, compliant and determined to positively affect their condition.  

Kegels for Men:

Kegels for men can help with erectile dysfunction and urinary and fecal incontinence. They are most effective when performed in a consistent, specific manner and progressed slowly over time. Here are a few ideas and tips for men to consider when performing kegels.

A kegel is a contraction of the pelvic floor muscles. It feels like a gentle pulling up and in of the pelvic floor followed by a relaxation of the entire muscle group. The kegel contraction begins with a slight lift of the tail bone moving forward as a gentle tightening of the muscles between and tail bone and pubic bone. Lastly, the lower abdominals contract slightly. Then the muscles gently release or relax. There may be a feeling of a reversal of the contraction sequence.

There is no need for weights as our body weight and gravity provide resistance. The contraction is a sub-maximal in effort. If kegels are performed too hard and too fast the result may be muscle soreness and aggravation of symptoms. Performing a submaximal contraction is key and mild muscle soreness may be expected.

Avoid breath holding when kegeling. Repetitive contraction of the pelvic floor while holding the breath could aggravate prior back injuries or make pelvic floor symptoms worse. Normal breathing is the standard when kegeling. Your face should not be turning red. After normal breathing while kegeling is mastered you can further enhance the kegel during exhalation. A long exhalation during a kegel - such as you would blowing out a candle - can allow you to improve muscle performance. Here, give it a try: gently tighten the pelvic floor – take a deep breath in and slowing exhale like you are blowing out a candle while holding the kegel muscle contraction. Then release.

Kegels should be progressed gradually and can be progressed by increasing the hold time and number of repetitions. For example, when you first begin kegeling, you will want to measure how long you can hold the muscle contraction before the muscles ‘give away’ and release the kegel. If you can hold one kegel for 3 seconds, without breath holding, use that as your benchmark for holding time.  Next, work your way up to 10 contractions of 3-second holds. Repeat another set of 10 later in the day. Eventually you may work up to completing multiple sets of 10, 3 to 5 times per day while advancing the kegel-hold time to 10 seconds. And, please remember to relax between each consecutive kegel to avoid moderate muscle soreness.

Try kegeling in different positions. Use the above suggestions of progressing the kegel hold time and repetition and apply to your place in space. The combined effect of body weight and gravity can increase the resistance and difficulty of the kegel. For example, if you have been performing your kegels while lying down, try to perform them in a seated position, followed by standing and during your daily activities.

Lastly, consistency and patience are key. If you don’t take your medicine you will not get well. Continue to perform your kegels daily while your symptoms are improving and to maintain your gains. Be creative and patient with progressing kegels. Depending on your starting point it may take weeks or months to progress to performing multiple repetitions in functional positions. Do not give up too soon. Kegels - they are not just for women and can greatly improve a man’s overall health and quality of life. Give them a try.

 
 Michelle Herbst, PT

Michelle Herbst, PT