Male incontinence

About male incontinence

The severity of urinary incontinence in men ranges from hardly noticeable mild incontinence to severe incontinence that affects every part of your life. You may experience varying degrees of urine loss, and the syndrome may change over time. For example, men with light incontinence may leak a little when they laugh or cough, while men with heavy incontinence may be experiencing continuous leakage. No two men are alike, and no two men are affected the same way.

Many men see incontinence as embarrassing. Some would rather admit to erectile dysfunction. This is a perception that needs to change.

Thousands of Singaporean men are living with the effects of bladder weakness. In fact, the affliction is so common that the government has finances available for incontinence sufferers. Incontinence is generally more prevalent in women than men, however older men and women suffer from incontinence in equal numbers.

Understanding your body makes it easier to take control and get the help you need to live your life as you want. In this article, we’ll start out with an overview of male incontinence and the three main variations. We will then identify some of the most common causes and treatments of male incontinence. Knowing the basics will help you understand your needs and how best to talk with your doctor or health care professional. In many cases, bladder control loss can be cured. Almost all cases can be managed.

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Male incontinence types

There are three main types of male incontinence:

  1. Stress incontinence: This type of male incontinence occurs when outside pressure causes an already weakened bladder to leak urine. This outside pressure may come in the form of a cough, laugh or from lifting a heavy object.
  2. Urge incontinence: This kind of male incontinence occurs when you get an extremely strong and sudden urge to go to the toilet, but you don’t always make it in time. Your bladder may also contract without you wanting it to, causing involuntary urine leakage.
  3. Overflow incontinence: This variation of male incontinence occurs when your bladder is overfilled, and you cannot seem to fully empty your bladder. The bladder then leaks out the excess urine later. This is the most common form of male incontinence due to the high incidence of enlarged prostates and prostate surgeries carried out in Singapore.

Male incontinence causes

Male incontinence is usually caused by a damaged sphincter, which is the circular muscle that controls the flow of urine out of the bladder. When damaged—in men, often due to removal of the prostate to treat cancer—the sphincter cannot squeeze and close off the urethra. This causes the urine to leak.

Prostate surgery

Prostate problems and the treatments required to correct them are the most frequent causes of urinary incontinence in men.
Common prostate problems:

  1. Prostatitis is infection of the prostate gland and may have to do with a urinary tract infection. It is more common in younger men.
  2. Benign prostatic hyperplasia (BPH) causes the prostate to get bigger over a period of time, usually starting in middle age. About 1 in 4 men will need surgery or medical treatment for this problem. BPH does not lead to cancer.
  3. Prostate cancer may be found at first without any symptoms. It is a fairly common cancer, the chances of getting it increases with age; however it is usually one of the most responsive to treatment.

Because early diagnosis is key to successful treatment, doctors recommend yearly prostate exams for men over the age of 50. Men with a family history of prostate cancer should begin these check-ups at age 40.

Most men have temporary incontinence following surgery for prostate cancer. The degree to which incontinence occurs, and the severity of it, varies with each man. While incontinence can be distressing, there are many treatments and management options available.

The good news is that it generally lessens within six months to one year. In many cases, continence is fully restored.

Other causes

Male urinary incontinence can also be caused by other medical conditions, including nervous system disorders or injury (Parkinson’s disease, stroke or spinal cord injury); certain medications, nutritional deficiencies, obstructed urination; some types of surgery; and certain birth defects or chronic medical conditions such as diabetes.

The good news is that, in many cases, incontinence can be cured and it can always be managed.

Find out more about incontinence causes.

Male anatomy

To understand the problem, it helps to understand how your urinary system actually functions.

  • Kidneys filter urine from the blood and this is stored in your bladder.
  • The bladder is a hollow muscular organ that holds the urine until you decide that you feel full (hopefully at about 300mls).
  • When you reach the toilet, you relax your pelvic floor muscles and your brain gives permission for the bladder muscle to contract, squeezing the urine out through the urethra – the tube from the bladder to the outside.
  • When the bladder muscle contracts, the muscle that holds the bladder outlet tube (urethra) shut during storage (called the sphincter), relaxes to allow the urine to pass through. In men, the urinary sphincter muscle is located below the prostate. The sphincter muscle surrounds the urethra.
  • The whole system is supported by the muscles of the pelvic floor that run from the tip of your tailbone through to the pubic bone (the front bone of your pelvis).

Urine is about 95% water and 5% waste. Some people incorrectly believe that by drinking less fluid, they will reduce their bladder control loss. In fact, urine that is more concentrated due to lack of fluid intake can irritate the bladder and cause more serious problems such as infection and dehydration. In addition, inadequate fluid intake can cause constipation, which may also make matters worse.