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Patient education: Urinary incontinence in males (The Basics)

Patient education: Urinary incontinence in males (The Basics)

What is urinary incontinence? — "Urinary incontinence" is the term doctors use when a person leaks urine or loses bladder control.

Incontinence is a very common problem, but it is not a normal part of aging. If you have urinary incontinence, you do not have to "just live with it." There are treatments and things you can do on your own to stop or reduce urine leaks.

What are the symptoms of urinary incontinence? — There are different types of urinary incontinence. Each causes different symptoms. In males, the 4 main types are:

Stress incontinence – With stress incontinence, you leak urine when you laugh, cough, sneeze, or do anything that "stresses" the belly. Some people get this type of incontinence after having surgery for prostate disease.

Urgency incontinence – With urgency incontinence, you feel a strong need to urinate all of a sudden. This is also known as "urge incontinence." Often the "urge" is so strong that you can't make it to the bathroom in time. "Overactive bladder" is another term for having a sudden, frequent urge to urinate. People with overactive bladder might or might not actually leak urine.

Mixed incontinence – With mixed incontinence, you have symptoms of both stress and urgency incontinence.

Incontinence caused by incomplete bladder emptying – This is when you cannot fully empty their bladder when you urinate. This can happen if you have a condition called "benign prostatic hyperplasia," which makes the prostate grow larger than normal. An enlarged prostate can block the flow of urine.

Is there anything I can do on my own to feel better? — Yes. Here are some steps that can help reduce urine leaks:

If you drink lots of liquids, ask your doctor or nurse if it is OK for you to reduce the amount you drink. This might help, especially in the hours before you go to bed.

Cut down on any foods or drinks that make your symptoms worse. Some people find that alcohol, caffeine, or spicy or acidic foods irritate the bladder.

Try to lose weight, if you are overweight. Your doctor or nurse can help you do this in a healthy way.

If you have diabetes, keep your blood sugar as close to your goal level as possible

If you take medicines called diuretics, plan ahead. These medicines increase the need to urinate. Try to take them when you know you will be near a bathroom for a few hours. If you keep having problems with leaking because of diuretics, ask your doctor if you can take a lower dose or switch to a different medicine.

These techniques can also help with bladder control:

Bladder retraining – During bladder retraining, you go to the bathroom at scheduled times. For instance, you might decide that you will go every hour. You would make yourself go every hour, even if you didn't feel like you needed to. And you would try to wait until a whole hour had passed if you needed to go sooner. Then, once you got used to going every hour, you would increase the amount of time you waited in between bathroom visits. Over time, you might be able to "retrain" your bladder to wait 3 or 4 hours between bathroom visits.

Pelvic muscle exercises – Pelvic muscle exercises strengthen the muscles that control the flow of urine. When done right, these exercises can help. But people often do them wrong. Ask your doctor or nurse how to do them right. They might suggest working with a physical therapist who has special training in these exercises.

Should I see my doctor or nurse? — Yes. Your doctor or nurse can find out what might be causing your incontinence. They can also suggest ways to help the problem.

Ask your doctor or nurse if any of the medicines you take could be causing your symptoms. Some medicines can cause incontinence or make symptoms worse.

Some people choose to wear pads or special underwear. These can help if you accidentally leak urine once in a while. But they can also cause skin irritation if you use them a lot. If you have incontinence, the best thing to do is talk to your doctor or nurse about how to treat it.

How is incontinence treated? — Your treatment options depend on what type of incontinence you have. Some of the treatment options include:

Medicines to relax the bladder – These medicines can help with urgency incontinence.

Medicines to improve urine flow – These medicines can help with incontinence related to an enlarged prostate.

Surgery to (figure 1):

Repair the tissues that support the bladder or hold it in place

Improve the flow of urine, for example by removing part of the prostate gland

Repair the muscles that control urine flow

Electrical stimulation of the nerves that relax the bladder

Devices, such as:

A "condom catheter" – This fits over the penis like a condom. It collects urine into a bag that is strapped to the leg.

A penis clamp – This squeezes the penis to keep urine from leaking out. It can be used only for a certain amount of time.

What will my life be like? — Many people with incontinence can recover bladder control or at least reduce the amount of leakage they have. The most important thing is to speak up about it to your doctor or nurse. Then work with them to find a treatment or therapy that helps you.

More on this topic

Patient education: Benign prostatic hyperplasia (enlarged prostate) (The Basics)
Patient education: Pelvic muscle (Kegel) exercises (The Basics)

Patient education: Benign prostatic hyperplasia (BPH) (Beyond the Basics)
Patient education: Pelvic floor muscle exercises (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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