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Male urinary incontinence: common and treatable

By Howard Seidman, Staff Writer, myOptumHealth

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Up to 59 million Americans may suffer from urinary incontinence. While most of them are women, a growing number of men have the problem, too.

The incidence of incontinence - the accidental leakage of urine - rises as men age, especially after age 65. But up to half of all men who suffer from it don't seek help, experts estimate.

Some of the reasons that men may not seek treatment for it are due to:

• The false belief that it's a normal part of aging
• Fear of possible surgery
• Low treatment expectations
• Embarrassment

The urinary tract

The bladder is like a bag that expands to take on urine, and contracts to push urine out. A sphincter muscle, which can constrict and relax when needed, surrounds the exit to the bladder. It connects to the urethra - the canal that carries urine to the outside. The urethra passes through the prostate gland in the penis.

Urinary incontinence may occur from:

• Damage to the sphincter or nerves
• An overactive bladder that contracts at the wrong time
• An enlarged prostate that blocks urine flow

These problems can cause:

• Sudden and frequent urges to urinate (urge incontinence)
• Incomplete emptying of the bladder, increasing urination frequency (overflow incontinence)
• Weak urine stream
• Trouble starting urine flow even with a full bladder
• Leakage of urine with laughing, coughing, or exercise (stress incontinence)

Causes of male incontinence

• Enlarged prostate. About 17 million men have an enlarged prostate. This can hinder the bladder's ability to empty and cause chronic urine retention. Without treatment, the bladder may swell and lose ability to contract and completely empty.
• Prostate cancer surgery. Male incontinence may be on the rise because more men are getting prostate surgery to treat cancer. About half of all men who have their prostates removed have urine leaks in the first six weeks after surgery. A year after surgery, about one in five may still have problems.
• Overactive bladder. This condition affects 33 to 34 million men and women in the U.S. Overactive bladder may be caused by:
• • Bladder or prostate infections
  • Kidney stones
  • Bladder cancer
  • Nerve damage from diabetes, Parkinson's disease, multiple sclerosis, surgery or strokes due to high blood pressure

The role of meds

Certain types of drugs can contribute to a bladder problem, even when they are for conditions unrelated to the urinary system:

• Diuretics (water pills)
• Sedatives and muscle relaxants
• Narcotics
• Antihistamines
• Some antipsychotics
• Certain antidepressants
• Some calcium channel blockers
• Anticholinergics
• Nasal decongestants
• Over-the-counter cold remedies

Prevention and treatment

You may help to prevent incontinence by:

• Controlling diabetes
• Preventing or treating constipation
• Keeping active
• Treating urinary tract infections
• Avoiding smoking
• Limiting alcohol and caffeine

Also remember that there is treatment for this problem. Men don't have to accept incontinence as a normal part of aging. You may get help from a family doctor. Or your doctor may refer you to a urologist, a specialist who can diagnose and treat urinary problems.

View the original Male urinary incontinence: common and treatable article on myOptumHealth.com 

SOURCES:

• Stothers L, Thom DH, Calhoun E. Urinary incontinence in men. In: Litwin MS, Saigal CS, editors. Urologic diseases in America. National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2007; NIH Publication No. 07-5512, pp. 195-217. Accessed: 11/20/2008

• National Association for Continence. Medications: how medications affect your bladder, prescription medications to treat incontinence. Accessed: 11/19/2008

• National Institute of Nursing Research. Long-term care for older adults. Urinary incontinence. Accessed: 11/20/2008

• American Cancer Society. Detailed guide: Prostate cancer surgery. Accessed: 11/19/2008