Facts on Male Incontinence

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June 10, 2014


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The prostate is the  gland that sits at the base of the bladder in males and is directly related to urinary function. As men get older, prostate issues are more common, and urinary incontinence can result.

Men over the age of 50 are urged to have regular checkups that include physical prostate exams.  Many don’t, however, because they are suffering with incontinence and are embarrassed.  It’s important to know, however,  that while embarrassing, incontinence is  increasingly treatable.

Types of Incontinence
There are several types of urinary incontinence. The most common forms are stress, urge, mixed, and overflow.

  • Overflow incontinence, when small amounts of urine leak continuously, is common in men who have benign prostatic hyperplasia (BPH or enlarged prostate).
  • Stress incontinence causes urine loss during activities, such as coughing, sneezing, laughing or exercising, that put pressure on the abdomen.
  • Urge incontinence results in sudden, uncontrollable loss of urine and frequent urination.
  • Mixed incontinence causes symptoms of both stress and urge urinary incontinence.
  • “With men, incontinence can begin with the urine stream becoming a littler slower with less control,” said Alan Seifer, M.D., a family medicine physician at Baptist Health Medical Group. “Statistics show that 20 percent of men over 65 have some leakage and that can be a result of enlarged prostate.”

    Prostate problems are the leading causes of incontinence in men, but they are certainly not the only ones. The primary risk factors for male incontinence in men are prostate cancer, benign prostate enlargement, urinary tract infections, prior pelvic surgeries (such as bowel resection or prostatectomy), diabetes, stroke or advanced age.

    “As men get older, their prostate can enlarge causing urinary frequency to increase and leading to getting up at night more often,” said Dr. Seifer. “And there’s often also urge incontinence, which is when you’re suddenly compelled to urinate.  Either type of incontinence can lead to leakage.”

    An enlarged or inflamed prostate can also cause difficulty in urinating, or “interrupted stream.”

    Prostate cancer surgery often results in incontinence issues. The main type of surgery for prostate cancer is known as a radical prostatectomy, when the surgeon removes the entire prostate gland plus some of the tissue around it.

    Treating Male Incontinence
    Most forms of male incontinence are treatable with medication, physical therapy or behavioral changes such as reducing alcohol, caffeine and certain medications.

    Physical therapy involves learning how to control the pelvic floor muscles

    The floor of the pelvis is made up of layers of muscles that  stretch like a hammock from the tail bone at the back to the pubic bone at the front. Pelvic floor muscles support the bladder and the bowel and play an important role in bladder and bowel control.

    Strengthening these muscles can reduce leakage and improve control.

    Pelvic floor muscle exercises are taught under the guidance of a specialized physical therapist, like  Louise Gleason, from South Miami Hospital’s Pelvic Health and Continence Testing department.

    “In general, men who walk through my door are already motivated to resolve this problem,” Ms. Gleason said. “They do pretty well. They receive enough information on the first visit to have context as to where the therapy is going.”

    Therapy Begins with Evaluation
    The session begins with an evaluation that includes a look at behaviors and habits, such as reducing the intake of alcohol and caffeinated drinks, that could be modified to help overcome incontinence, Gleason said.

    “We give them the tools to manage their own situation,” she said. “It’s not an all-or-nothing fix. But now they have the knowledge and techniques to treat the problem at home. This should be a life-long change.”

    Dr. Seifer emphasizes that male incontinence is common as men get older. They shouldn’t get discouraged or be embarrassed. Men should get a good check-up by their family doctor and review any medications or bad habits that may be contributing to the problem, he stressed.

    “There are some good medicines that help shrink the prostate and some the help relax the muscles to help with urinary functions,” said Dr. Seifer. “There are treatments available that can help most men regain control of their prostate and urinary health.”

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