Loss of urine is one of man’s most devastating maladies. It usually is related to problems with the bladder or the prostate gland especially after prostate gland surgery.
Male Stress Urinary Incontinence (SUI) also known as, Post-Prostatectomy Incontinence, commonly occurs following a surgical procedure to remove a cancerous prostate. Studies have indicated that as many as 90% of men report leakage in the first few weeks following surgery for removal of the prostate gland, after removal of the catheter. Over the course of the first year, SUI can be a significant problem impacting the quality of life of men who suffer from this condition.
Fortunately, there are effective treatment options for many cases of post-prostatectomy incontinence. Men often say the leakage from post-prostatectomy incontinence is worse than the actual cancer. Unfortunately, there is a lack of information for men with stress urinary incontinence.
Urinary incontinence can be short-term or long-lasting (chronic). Short-term incontinence is often caused by other health problems or treatments.
Chronic urinary incontinence can be categorized as:
• Stress incontinence means that you leak urine when you sneeze, cough, laugh, lift something, change position, or do something that puts stress or strain on your bladder.
• Urge incontinence is an urge to urinate that’s so strong that you can’t make it to the toilet in time. It also happens when your bladder squeezes when it shouldn’t. This can happen even when you have only a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence. But not everyone with an overactive bladder leaks urine.
• Overflow incontinence means that you have the urge to urinate, but you can release only a small amount. Since your bladder doesn’t empty as it should, it then leaks urine later.
• Total incontinence means that you are always leaking urine. It happens when the sphincter muscle no longer works.
• Functional incontinence means that you can’t make it to the bathroom in time to urinate. This is usually because something got in your way or you were not able to walk there on your own.
Different types of incontinence have different causes.
• Stress incontinence can happen when the prostate gland is removed. If there has been damage to the nerves or to the sphincter, the lower part of the bladder may not have enough support. Keeping urine in the bladder is then up to the sphincter alone.
• Urge incontinence is caused by bladder muscles that squeeze so hard that the sphincter can’t hold back the urine. This causes a very strong urge to urinate.
• Overflow incontinence can be caused by something blocking the urethra, which leads to urine building up in the bladder. This is often caused by an enlarged prostate gland or a narrow urethra. It may also happen because of weak bladder muscles.
In men, incontinence is often related to prostate problems or treatments.
Drinking alcohol can make urinary incontinence worse. Taking prescription or over-the-counter drugs such as diuretics, antidepressants, sedatives, narcotics, or nonprescription cold and diet medicines can also affect your symptoms.
The diagnosis is easily made with a careful history and physical exam. Your doctor will do a test on your urine to be certain there is no evidence of infection. Often this is enough to help the doctor find the cause of the incontinence. You may need other tests if the leaking is caused by more than one problem or if the cause is unclear.
Treatments depend on the type of incontinence you have and how much it affects your life. Your treatment may include medicines, simple Kegel exercises, or both. A few men need surgery, but most don’t.
There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.
• Cut back on caffeine drinks, such as coffee and tea. Also cut back on fizzy drinks like soda pop. And limit alcohol to no more than 1 drink a day.
• Eat foods high in fiber to help avoid constipation.
• Don’t smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Stay at a healthy weight.
• Try simple pelvic-floor exercises like Kegels.
• Go to the bathroom at several set times each day and avoid your bladder getting to full. Wear clothes that you can remove easily. Make your path to the bathroom as clear and quick as you can.
• When you urinate, practice double voiding. This means going as much as you can, relaxing for a moment, and then going again.
• Use a diary to keep track of your symptoms and any leaking of urine. This can help you and your doctor find the best treatment for you.
If you have symptoms of urinary incontinence, don’t be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.
Bottom Line: Urinary incontinence in men affects their quality of life. Help is available and it begins with sharing the problem with your doctor.