Though urinary incontinence is more common in women, an estimated 11 to 34 percent of older men have some form of urinary incontinence. Contrary to popular belief, bladder leakages are not necessarily a normal part of aging but can, in fact, be treated. However, treating male incontinence depends on understanding the cause of your symptoms.
Male incontinence causes range from lifestyle factors to serious health conditions to chronic conditions, such as overactive bladder (OAB). Keep reading to learn more about common male incontinence causes and the different treatment options available.
What is urinary incontinence?
The loss of bladder control or inadvertent urine leakage is referred to as urinary incontinence. Understanding the anatomy around the bladder and urethra can help clarify the cause of bladder leakages in men.
Urination is controlled by the interaction of the kidneys, which produce urine; the bladder, which stores urine; the urethra, which carries the urine outside the body; and urinary sphincter muscles that surround the urethra. Nerve signals tell the sphincter to stay tightened as the bladder fills and to relax when it is time to urinate, allowing the bladder to squeeze the urine out through the urethra. When this process does not occur properly, the bladder can leak urine.
Types of urinary incontinence
There are several types of urinary incontinence that cause different symptoms and can be tied to different causes. It is common for individuals to experience multiple types of incontinence.
- Stress incontinence: Bladder leakage caused by physical stressors such as sneezing, coughing, laughing, lifting something, or doing anything that puts stress or strain on the bladder
- Urge incontinence: Bladder leakage caused by an urge to urinate that’s so strong that urine is released before you can make it to the toilet (regardless of whether the bladder is actually full)
- Mixed incontinence: The presence of both stress incontinence and urge incontinence
- Overflow incontinence: Bladder leakage caused by the bladder not emptying properly when full, so urine leaks out later
Male incontinence: causes
Several anatomical factors can interfere with the bladder control process described above, such as:
- Weakened muscles around the urethra (urinary sphincter)
- The bladder not emptying when it should, leading to an overflow of urine
- Blockages in the urethra, causing a buildup in the bladder
- The bladder contracting inappropriately or with excessive force
But what would cause weakened muscles or abnormal bladder emptying in the first place? The underlying cause could be a health condition, a medical event such as surgery, or lifestyle factors, such as those in the list below.
- Chronic cough – Coughing can trigger stress incontinence.
- Urinary tract obstruction – Several medical factors can cause blockages in the urinary tract, such as injuries in the pelvic region, tumor masses, digestive tract diseases, kidney stones in the urethra, or blood clots. When urine flow is obstructed, overflow incontinence can occur.
- Nerve damage – Nerve damage can interfere with the functioning of the bladder muscle or sphincter muscles, resulting in a loss of control of the storage or release of urine.
- Bladder or urinary tract infections – Incontinence may be brought on by specific infections.
- Neurological disorders – Neurological disorders such as Parkinson’s can interfere with bladder control signals and cause leakages.
- Enlarged prostate – An enlarged prostate, also called benign prostatic hyperplasia (BPH), can put pressure on the urethra, causing an obstruction that can lead to overflow incontinence, or directly on the bladder, leading to urge or stress incontinence.
- Prostate cancer – Prostate cancer can damage the nerves around the urinary tract or cause urinary tract obstruction.
- Prostate surgery or radiation – Treatments for prostate problems or prostate cancer can also cause nerve damage, as well as bladder spasms or stress incontinence.
- Lifestyle factors – Smoking, drinking alcohol, lack of exercise, and obesity can all contribute to or exacerbate urinary incontinence.
Urinary incontinence may indicate an overactive bladder (OAB).
Not all urinary incontinence is the result of a health condition such as the ones mentioned above. When urinary incontinence is chronic and/or accompanied by frequent urination (urinating eight or more times per day), urgency (strong and sometimes uncontrollable urges), and nocturia (waking up more than one time per night to use the restroom), urinary incontinence may indicate overactive bladder (OAB).
OAB affects an estimated 50 million Americans and is a chronic condition, so there is no cure. However, symptoms can be drastically reduced through strategic treatments.
Treating male incontinence
Incontinence doesn’t have to be a normal part of daily life. When male incontinence is caused by specific medical events or health conditions, those conditions will need to be treated in order to address the source of your symptoms. However, OAB-related incontinence can be successfully treated through the care pathway described below.
First-line treatments: Behavioral interventions
The first treatments doctors will recommend for incontinence in men are typically behavioral interventions. These include:
- Bladder diaries – Bladder diaries are diagnostic tools where a patient tracks their symptoms, such as the time of bladder leakage, frequency of bladder leakage, and possible triggers.
- Bladder training – A patient can “train” the bladder to function properly through strategies such as scheduled bathroom breaks and delayed urination.
- Pelvic floor or Kegel exercises – The muscles of the bladder can be strengthened by these workouts.
- Dietary changes – Incontinence symptoms may be reduced by cutting down on foods or fluids (such as caffeinated drinks and alcohol) that exacerbate bladder problems.
- Lifestyle changes – Stopping smoking, exercising more, or losing weight can help reduce OAB symptoms such as incontinence.
Second-line treatments: Medication
If symptoms are not resolved through behavioral interventions alone, there are several medications available. These medications have different mechanisms depending on the underlying cause of your incontinence symptoms, and you may need to try several different medications to find one that works for you.
Advanced therapies
If lifestyle changes or medications are not successful, doctors may recommend advanced therapies such as Botox injection, surgery, or electrical stimulation.
