What Causes Incontinence In Men

What Causes Incontinence In Men?

Bladder leaks can happen to anyone at any age. While we’ve been conditioned to think that mostly older women are affected by the condition, many men suffer from incontinence too. 

There are many conditions that can lead to urinary incontinence in men. But luckily there are also many ways to treat it. Keep reading to learn some of the reasons men develop leaky bladders, how it’s diagnosed, and ways to treat it.

What is urinary incontinence?

Urinary incontinence is the accidental leakage of urine. Many people wrongly assume that developing urinary incontinence is something that just happens as you age. This couldn’t be further from the truth. It can develop in anyone, at anytime. And there are several possible causes for it.

First, let’s start off with learning a bit about how everything works.

The urinary system is composed of two kidneys, two ureters, a bladder, and a urethra. The kidneys remove waste products from the blood and continuously produce urine. The muscular, tube-like ureters move urine from the kidneys to the bladder, where it is stored until it flows out of the body through the urethra. A circular muscle, called the sphincter, controls the activity of the urethra and keeps urine in the bladder until it is time to urinate.

Normally, the bladder wall is relaxed while storing (or filling with) urine and the urethra is closed off by the sphincter. Your pelvic floor muscles also help keep the bladder outlet closed by supporting the urethra.

When the bladder is working correctly, the bladder sends signals to the brain to let you know how full it is, and to the sphincter to tell it to stay closed and prevent the bladder muscle from contracting.

When the bladder is full, you allow the pelvic floor as well as muscles at the outlet of the bladder to relax and open up. As this is happening, the muscle in the wall of the bladder (detrusor muscle) begins to contract and continues contracting until the bladder is completely emptied.

This process of bladder filling and emptying is obviously very complex. When any part of the urinary system or pelvic floor does not work correctly, incontinence can result.

If any of these signals don’t happen or get confused, bladder leakage can happen. 

What causes urinary incontinence in men?

Many things may contribute to bladder leakage in men.

The most common reason men experience incontinence is due to problems with the prostate. As men age, the prostate gland grows. It is estimated that 17 million men have an enlarged prostate, or symptoms of Benign Prostate Hyperplasia (BPH). The prostate gland wraps around the urethra (the bladder outlet), so an enlarged prostate can constrict or block the urethra. This is known as prostatic obstruction.

Prostatic obstruction can compromise the bladder’s ability to effectively empty, causing chronic retention of urine. This contributes to urgency and frequency because the bladder still signals that it needs emptying. If left untreated, the bladder can become distended, worsening its ability to contract and completely empty. It is possible to have prostatic obstruction even if the prostate is not enlarged.

Men may also experience Overactive Bladder (OAB) which is characterized by a sudden and urgent need to urinate, and needing to urinate frequently. This becomes urgency urinary incontinence when you are not able to reach the bathroom before losing control of the bladder.

Additionally, conditions that cause damage to the nerves, such as diabetes can cause bladder problems since it disrupts the normal signaling from the bladder to the brain to help control bladder function. Other conditions, such as stroke, can also cause incontinence, and even some medications or certain foods or drinks can contribute to urinary incontinence. 

How is urinary incontinence in men diagnosed? 

Before your appointment, take note of your symptoms so that you can relay them to your doctor. Symptoms of incontinence to look for are:

  • Diminished or interrupted urine flow

  • An urgent or sudden need to urinate

  • Increased frequency of urination

  • Inability to empty the bladder completely when urinating

  • Difficulty starting the urine flow, even when the bladder feels full

  • Getting up more than once per night to urinate (nocturia)

  • Accidental urine leakage

Talking to your doctor is the first step toward treatment.  At your appointment, your doctor will likely ask for your medical history, give you a complete physical examination, and provide a urine specimen. You may be asked to keep a bladder diary to record your symptoms.  Other tests to examine the bladder and/or prostate may also be necessary. 

Once your doctor has diagnosed your bladder condition, you can work together to decide on a treatment option that best fits your needs and works with your lifestyle.

What treatment options exist for men with urinary incontinence?

The good news is that there are lots of treatments available to men with urinary incontinence.  Your treatment path will depend on what is causing your condition.

For men with an enlarged prostate, your doctor may recommend medications to reduce symptoms and reduce the size of the prostate. Minimally invasive treatments, or even surgery is sometimes done to increase the flow of urine.  

Men with OAB may also be prescribed medications to help calm the bladder.  In cases where medication is not an option or isn’t working, minimally invasive treatments such as InterStim may be used.  This is an implanted device that helps to establish more normal function of the bladder by gently stimulating the sacral nerve. Behavioral modifications can also help with OAB. Changes in your diet, bladder training, and pelvic floor muscles are often used to help control urinary incontinence caused by OAB.

Many men also experience incontinence after prostate cancer surgery. When the prostate gland is removed, damage may occur to nerves, tissues, and the sphincter muscle that can impair the bladder's ability to store urine without leaking. This may last for just a few months during recovery, or longer. Depending on the severity of incontinence, there are several options that may help.  

Performing pelvic muscle exercises (kegels) are an important part of treating incontinence in men. Kegel exercise done before and after surgery can help to recover bladder control and are important for maintaining erectile function.  When done correctly, kegels can strengthen the muscles that support the bladder, causing fewer leaks, and improving bladder and bowel control. (Click here for a men’s guide to doing kegels.)

 If additional help is needed, other surgical options may be available. Your doctor can talk about the pros and cons of the various surgical options available.

Seeking Help Is The First Step

If you’re struggling with urinary incontinence, the most important thing to remember is that help is available. It’s not just a women’s issue – MANY men live with this condition too and there is no need to suffer in silence.  Talk with your doctor to learn the root cause of your bladder leakage and to find a treatment that works for you. 

What Causes Incontinence In Women?

What Causes Incontinence In Women_.jpg

Incontinence is a condition that affects over 25 million men and women in America. It can really happen to anyone, and can be caused by many different things. But it is much more common in women – nearly twice as common actually – and unfortunately has become something that many people (even potentially your doctor) brush off as being a normal part of aging. This couldn’t be further from the truth.

Why Is Incontinence More Prevalent In Women?

Incontinence can have many root causes.  Being overweight, problems with the prostate in men, and even conditions that cause damage to the nerves, such as multiple sclerosis, Parkinson’s disease, or even diabetes can all lead to incontinence.  But it’s no secret that women suffer from incontinence more than men. This is in part due to the fact that things like pregnancy, childbirth, and menopause are unique to women and create extra pressure and complications that can cause incontinence. 

The pressure of carrying a baby for 9 months and the trauma of childbirth to the pelvic floor can weaken the pelvic floor, making it difficult to stay continent.  Additionally the hormonal changes that occur during menopause cause a change in continence.  A decrease in estrogen can cause the vaginal tissues to become less elastic and dry and can lead to incontinence and urinary tract infections.

What Types Of Incontinence Are There 

Did you know that there are actually different types of Incontinence? Depending on what you have, there may be different options available to you.

Urge Incontinence

Urge incontinence is the frequent and urgent need to use the bathroom, accompanied by bladder leakage.  You may have a sudden feeling that you have to go to the bathroom right now, or it may be triggered by familiar things, such as arriving home, washing the dishes, etc. This type of condition may also exist without bladder leakage, and is then referred to as Overactive Bladder. 

Stress Urinary Incontinence

Stress urinary incontinence happens when pressure is placed on the bladder and causes bladder leakage. This type of leakage might happen when you’re working out, or even when you sneeze or laugh. Unlike Urge incontinence, stress urinary incontinence is not typically accompanied by the sensation of a sudden urge to urinate. Rather, stress urinary incontinence is caused by a weakened pelvic floor, and/or a weak sphincter muscle.  Stress urinary incontinence often occurs in women (although men can have it too), and typically as a result of pregnancy and childbirth. It’s a condition that can get worse as you get older, since we lose pelvic muscle tone as we age. Luckily, there are many treatment options available, and behavioral modifications, such as learning how to create a healthy pelvic floor, can do wonders for this type of incontinence.

Mixed Incontinence

As the name implies, many women can suffer from both Stress Urinary Incontinence, and Urge Incontinence, although one is typically more severe than others. Treatment options for mixed incontinence are typically the same as the treatments you would use for stress urinary incontinence, or urge incontinence.

What Are My Options?

Luckily, there are many treatment options available for the various types of incontinence women tend to have.  Below are just a few treatment options available.

Behavioral Modifications.

Often, simple changes to our lifestyle, including changes to our diet and exercise regimen, can ease a lot of the symptoms of incontinence in women.  Learning the foods and drinks that irritate the bladder, and knowing how to strengthen the core and pelvic floor muscles can do a great deal to help reduce or even eliminate symptoms.

 Absorbents

Absorbent products come in all shapes and sizes and are a great option for those who need some extra protection. Read our guide to finding the right absorbent product for you.

 Medications

There are many types of medications available that can sooth an irritable bladder. These medications typically work by relaxing the muscles around the bladder, or stopping the signal to your bladder that you need to go right now!

Procedures

If medications and behavioral modification don’t work for you, there are several options that you may want to try before you think about surgery. Many women have seen success with botox injections into their bladder (it’s not just for wrinkles!), and different forms of neuromodulation, small pulses that stimulate the nerves involved in controlling the bladder.  Learn more about these options here.

Surgery

Finally surgery can be a good option for those who have tried other treatments without success. There are several types of surgical procedures, including urinary diversion, sling procedures, and augmentation cystoplasty, that can help with incontinence in women.

It’s important to note that no treatment is 100% effective all the type. Talk with your doctor about what you can expect with each treatment, as well as the pros and cons associated with them.

Urinary incontinence can have a big impact on a woman’s life and it’s important to get it treated.  Too many women live with symptoms of urinary incontinence, thinking it’s just a normal part of aging. But there are many treatments available and it can make life so much more enjoyable when you’re not looking for a bathroom or worried about having an accident. 

If you live with urinary incontinence, make an appointment with your doctor to talk about treatment options.  

Ask The Expert: Is Urinary Incontinence A Normal Part Of Aging?

Is Urinary Incontinence A Normal Part Of Aging?

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: Is Urinary Incontinence A Normal Part Of Aging?

Answer: We get this question all the time, and suspect that many people believe this, even though it’s not really true. Here are the facts:

While incontinence should never be considered a normal occurrence, our chances of getting it do increase as we get older. Certain life events (childbirth, for example) can cause the muscles and tissues to weaken, and, over time can result in urinary incontinence. Other conditions can also play a role – neurological conditions such as MS or Parkinson’s Disease, being overweight, or prostate problems in men can all contribute to bladder leakage.

So, in a way, yes, as you get older, you may be more likely to experience urinary incontinence, but it’s typically a symptom of something else. And it most certainly can be treated. Lifestyle changes, such as diet and exercise (especially performing moves that increase the strength of the pelvic floor) can do wonders in improving symptoms of incontinence. And, if that doesn’t work, medications, minimally invasive procedures (like Botox injections or InterStim) or even surgery are all options for treating the issue.

The most important thing to take away is that having bladder leakage is not a lost cause. If you live with this symptom, find a doctor and talk about your options. Life’s too short to live with a condition that has so many options for treatment.

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!

UTIs - What Causes Them And How To Avoid Them

UTIs - What Causes Them And How To Avoid Them

UTIs, or Urinary Tract Infections, will affect most women at some point in their lifetime.  UTI’s are recognized by the burning sensation they cause in the bladder or urethra (the tube that empties urine from the body) during urination, and the intense urge to urinate frequently – even if it is just a little amount.  Some women may also leak urine during a UTI, even if that isn’t something they normally experience.  Urine may also smell differently and appear cloudy or dark. 

UTI’s are not pleasant, but there are things you can do to prevent them.

The first thing you need to know is why UTIs happen.  UTIs are caused by the presence of bacteria in the urinary tract, which can then travel up to the bladder.  And, while the urinary tract does have several safe guards, which naturally help it to flush bacteria out, infections can still occur.  Infections are more common in women primarily due to their anatomy.  Bacteria from the bowel can easily sneak into the urethra because it is so close to the anus (This is why we wipe front to back people!), and women have much shorter urethras than men, which means bacteria can more easily get into the bladder.   Certain conditions can make people more prone to UTIs – those who wear catheters may be at an increased risk since it is harder to flush bacteria out of the urinary tract. And anyone who has trouble emptying his or her bladder completely can also be at risk.  Sex can also contribute to UTIs since it can introduce new bacteria to the urethral opening.

The good news is that most UTIs don’t last long once treated.  Since the main cause of a UTI is often the presence of bacteria, antibiotics are usually used to treat them, and take roughly 2-3 days to work.  Drinking lots of water and fluids can also quicken your recovery time, because it helps you to flush out the bacteria out of your system. 

Here are some tips to avoid UTIs altogether:

Wipe front to back.

Keeping the Urethra clean and avoiding contact with bacteria from the anus or bowel can help prevent bacteria from entering the urinary tract in the first place.

Drink lots of fluids. 

Staying hydrated and drinking lots of water each day will help flush out any bacteria that may be present.

Urinate when you need to.

Holding urine in the bladder for longer than necessary only increases the chance that bacteria will multiply and cause an infection.

Urinate after having sex.

This helps get rid of any bacteria that may be lingering from intercourse.

If you do get a UTI, see a doctor right away for treatment. If left untreated, the bacteria can sometimes make its way to the kidneys and cause a more serious infection.