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: 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

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!

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

Know The Symptoms Of Prostate Cancer

Know The Symptoms Of Prostate Cancer

Know The Symptoms Of Prostate Cancer

Apart from skin cancer, prostate is the most common cancer among men.  And while a large number of men are diagnosed with the condition each year, the survival rate for prostate cancer is generally high if caught early on. There are no warning signs, which is why it is important for men to begin getting screened for prostate cancer at age 50.  However, common symptoms often emerge once the cancer has already started.  These may include any of the following:

  • Frequent urination
  • Weak urine stream
  • Inability to empty the bladder
  • Leaking urine
  • UTI’s, which may feel like a burning sensation during urination or ejaculation
  • Blood in the urine or semen
  • Erectile dysfunction
  • Bone pain or discomfort, especially in pelvis or lower part of the body

It’s important to note that many of the above symptoms can have other causes too.  Enlarged prostate can cause many of the same symptoms as prostate cancer due to the extra pressure placed on the urethra.  Talk to your doctor about any symptoms you’re experiencing so he or she can determine the appropriate course of action.

Need help finding a physician? Use the NAFC Specialist Locator to find one near you.

With Incontinence Treatment, Educating Yourself Is Half The Battle

Millions of Americans experience some form of incontinence.  And, while this condition affects both genders, if you are a woman, you are more likely to suffer from incontinence than men due to things like pregnancy, childbirth, and menopause. 

There are several different types of incontinence you may experience:

  • Stress Urinary Incontinence:  SUI occurs when any extra pressure placed on your bladder or abdomen causes you to leak urine.  Things like sneezing, laughing, or certain exercise all may trigger SUI.   
  • Urge Incontinence: Also known as Overactive Bladder, Urge Incontinence is the sudden, frequent feeling that you need to use the restroom. 
  • Mixed Incontinence: Many people suffer from both Stress Urinary Incontinence and Urge Incontinence combined.
  • Urinary Retention: This type of incontinence occurs when you are unable to completely empty your bladder, leading to leaks. 

The good news is that all of these conditions are treatable.  And now, more than ever, there are countless options for treatment, so if you haven’t yet found something that works for you, try again!  Here are some popular treatment options:

  • Absorbent products: Probably one of the most widely used treatment options, absorbent products are a good first line treatment for those who experience leaks.  There are many different types and fit is very important, so expect to try out a few and see what works best for you. And whatever you do, don’t use sanitary pads in place of absorbent products specifically designed for leaks – the two are made of different materials and sanitary pads are not designed to hold urine, so leaks are likely to occur if you use them for that purpose.
  • Behavioral Therapy:  Before trying out medication or other procedures, you may want to tweak some of your behaviors to see if they have any effect.  Things like altering your diet to eliminate bladder-irritating foods, starting a physical therapy routine, or practicing bladder retraining can all have an effect on managing your symptoms.
  • Medications: There are a number of medications that may help you with bladder control.  Most medications work by calming the bladder and reducing the spasms that sometimes happen and cause leakage.  Talk with your doctor about the different types and learn what may work best for you.
  • Non-invasive procedures: If you’ve tried medications and have not seen results, or experienced unwanted side effects, you may want to give a non-invasive procedure a try.  InterStim, Botox, and PTNS are all simple procedures that can be administered in a urologist’s office and can have a significant effect on symptoms and quality of life.  Talk with your doctor to learn more about these procedures and what you can expect if you choose to go this route.
  • Surgery:  Several surgical options exist for those experiencing urinary incontinence.  Surgery is often a more permanent solution, and is a common approach for many who have failed on other treatment plans.  But, it’s not for everyone, and may not always eliminate all your symptoms.  Be sure to talk to your doctor (usually a urological surgeon) about what may work for you and what you can expect after surgery.

Finding the best treatment plan for you requires you to play an active role.  Know your options and educate yourself about the different treatments available so you are better able to discuss them with your physician and make an informed decision together. 

To find a specialist in your area, visit the NAFC Specialist Locator and make an appointment today!

Integrate Kegels Into Your Daily Workout Warmup

Integrate kegels into your workout warmup

Going from zero to 60mph is great for your new two-seater racing car, but not for your muscles. It’s important to slowly gain speed in your workout routine, making your warm up routine a prime time to work your pelvic floor.

Strengthening your pelvic floor will help restore muscle function and lessen the symptoms of incontinence. Kegels are the primary pelvic floor exercise.

Whether you’re jogging, running, hiking, biking, or playing a contact sport, warming up is crucial to your exercise plan, so why not incorporate kegel training into your daily routine to help strengthen your pelvic floor muscles?

Here are a few suggestions for including kegels in your warm up routine:

  • Walk for 3-5 minutes at a steady pace. Take a break at a corner on your block or a turn on a trail and do 10 pelvic floor holds.

  • Do 10 lunges and 10 wall-sits for three reps. Between rotations, practice 5 kegels.

  • Practice a forward fold to stretch your hamstrings and back. Hold the fold 10-15 seconds, then stand and hold a kegel for 5-10 seconds. Repeat for 2-3 times.

  • Do jumping jacks or jump rope for 30-second intervals. Between each interval, practice 10 kegels.

Both men and women have pelvic floor muscles and both men and women experience a lack in pelvic floor strength as they age. Learn more about the importance of working your pelvic floor here. And find instructions on how to properly kegel, or lift your pelvic floor, here.  It is important to remember to let your muscles relax between contractions and to work all the muscles of your core to ensure optimal pelvic floor strength.  If you are unsure of the exercises that would work best for you, finding a physical therapist specialized in pelvic floor strengthening can be very helpful in creating a routine.

If you are looking for more ways to warm up before your work outs, we suggest heading over to workoutlabs.com. You can make your own printable full-body warm up graphic so you always have examples at hand. Print your own sheet out and add kegels wherever you feel most comfortable.

See our favorite full body warm up rotation below. Click here to make your own

How Your Spouse Can Keep You Honest

How Your Spouse Can Keep You Honest

When you first met your spouse years ago, you were enthralled with how they made you feel. Seeing one another and spending time together was really all you needed to feel giddy, happy, and complete.

Life continued its course, your relationship progressed, and with the years came successes and challenges. Honesty, with both with your partner and yourself, likely played a huge factor in how you tackled those challenges.

Tackling your incontinence deserves the same level of honesty you’ve used in other situations. The person you chose to spend the rest of your life with is your best mirror and they will have the most insight into how to keep you accountable with your care and how to help you live a full life. To leave them out of the conversation about your health is taking away one of the best assets you will have in managing your care and moving away from embarrassment and secrecy.

We believe honesty is the best policy and asking for help is a good thing. We also believe that those who are most close to you can be the biggest supporters in your life. Use that insight and commitment to your advantage and ask for help in every day things. Practicing this in other aspects of life will trickle into your health, too!

Here are five ways your spouse can keep you honest:

1. Pick a designated time during the day or the week when you give one another one piece of positive reinforcement and one suggestion for improvement.

Example of positive reinforcement: “You were so helpful this week doing the laundry while I was at coffee with my friend.” OR “I think John really appreciated your phone call to him this weekend—great job reaching out!”

Example of a suggested improvement: “Next time you call me on your way to work, could you please say ‘I love you’?” OR “I felt like you didn’t really want to help me rake the yard this weekend. Next time I ask for help can you be up front if you’re in a bad mood?”

2. Choose a household item that can serve as a reminder to you that you need to check-in with your treatment plan.

This could be a figurine, candle, or paperweight. Decide on a place for this item to be placed and ask your spouse to put this item in that designated place when they think you need to re-evaluate your treatment plan. Maybe you haven’t been taking your medicine as prescribed or you’ve avoided drinking water like your doctor recommended.

Let this object be a check in that your spouse can initiate.  

3. Swap household duties (within reason) with your spouse for one week and report back at the end of the swap.  Discuss ways you have both made assumptions about the other’s work or how you can display gratitude for their help more often. 

Pick a few chores that your significant other typically does and do them for a week instead. Report back to them at the end of the week and discuss the challenges of walking in their shoes for a week.

4. Designate a jar or vase on your dresser or somewhere in your personal space that serves as a compliment jar.

Ask your spouse to use this jar as a way to compliment you on areas of treatment you’re excelling in. Use the jar in the same way for areas of their health and life they’re looking to improve.

Read the compliments before going to bed every week or every month.

5. Give yourself a report card every season and ask your spouse to check your grading.  

Sketch a basic grading rubric with boxes for each area of life you’re looking to improve in (i.e. sleep, diet, exercise, downtime, community), fill out your own evaluation, and go over the details with your spouse. Discuss goals you can set to improve in the next season.

Tell us how you keep the lines of communication open with your spouse in the comments below.