What is urinary incontinence in men?

Urinary incontinence is the accidental release of urine. It's not a disease. It's a symptom of a problem with a man's urinary tract .

Urine is made by the kidneys and stored in a sac made of muscle, called the urinary bladder. A tube called the urethra leads from the bladder through the prostate and penis to the outside of the body. Around this tube is a ring of muscles called the urinary sphincter. As the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.

When you have to urinate, the nerve signals tell the muscles in the walls of the bladder to squeeze. This forces urine out of the bladder and into the urethra. At the same time the bladder squeezes, the urethra relaxes. This allows urine to pass through the urethra and out of the body.

Incontinence can happen for many reasons:

• If your bladder squeezes at the wrong time, or if it squeezes too hard, urine may leak out.
• If the muscles around the urethra are damaged or weak, urine can leak out even if you don't have a problem with your bladder squeezing at the wrong time.
• You can also have incontinence if your bladder doesn't empty when it should. This leaves too much urine in the bladder. If the bladder gets too full, urine will leak out when you don't want it to.
• If something is blocking your urethra, urine can build up in the bladder and cause leaking.

Urinary incontinence happens more often in older men than in young men, but it's not just a normal part of aging.

What are the different types of urinary incontinence?

Urinary incontinence can be short-term or long-lasting (chronic). Short-term incontinence is often caused by other health problems or treatments. This topic is about the different types of chronic urinary incontinence:

• Stress incontinence happens when you sneeze, cough, laugh, lift objects, or do something that puts stress or strain on your bladder and you leak urine.
• 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 happens when your bladder doesn't empty as it should and then leaks urine later. This happens when bladder muscles are weak or the urethra gets blocked. These blockages can be related to an enlarged prostate or a narrow urethra.
• Total incontinence happens when you are always leaking urine. It happens when the sphincter muscle no longer works.
• Functional incontinence is rare. It happens when 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.

What causes urinary incontinence in men?

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. The sphincter may be too weak to hold back the urine. And any extra pressure from sneezing, coughing, or straining can cause urine to leak.
• 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. Doctors don't know why this happens. But sometimes it can be caused by other urinary problems.
• 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. Over time, the bladder gets so full that pressure builds up and forces the extra urine to move past the blockage and out of the bladder. Overflow incontinence 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 non-prescription cold and diet medicines can also affect your symptoms.

What are the symptoms?

The most common sign of urinary incontinence is leaking urine from the bladder. Other signs will depend on the type of urinary incontinence you have.

• Stress incontinence: You release a small amount of urine when you cough, strain, lift something, or change position.
• Urge incontinence: The need to urinate is so strong that you can't reach the toilet in time.
• Overflow incontinence: You have the urge to urinate, but you can only release a small amount. And you can't control the constant dribbling of urine.

How is the cause of urinary incontinence in men diagnosed?

Your doctor will do a physical exam, ask questions about your symptoms and past health, and test your urine. Often this is enough to help the doctor find the cause of the incontinence. You may need other tests if the incontinence is caused by more than one problem or if the cause is unclear.

How is it treated?

Treatments are different for each person. They depend on the type of incontinence you have and how much it affects your life. After your doctor knows what has caused the incontinence, your treatment may include medicines, simple exercises, or both. A few men need surgery, but most do not.

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 don't drink more than one alcoholic 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 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.
• Keep track of your symptoms and any leaking of urine with a bladder diary. 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.

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