Urinary incontinence (UI) causes accidental leakage of urine. It isn’t a disease, but rather a symptom of another condition. This underlying medical issue causes a loss of bladder control.
Both men and women experience UI. The number of people who develop UI increases with age. This is especially true for men. Older men are more likely to experience UI than young men.
Here, you will learn more about UI, what causes it, how to treat it, and how to adjust to life with the symptoms.
Urinary incontinence is a symptom of another condition or issue. Certain types of UI can cause symptoms in addition to urine leakage.
These types of UI and symptoms include:
- Urgency incontinence: You feel a sudden, urgent need to urinate, followed by accidental leakage.
- Stress incontinence: Urine leakage is brought on by quick movements or pressure, such as from coughing.
- Overflow incontinence: Your bladder is so full that you have leakage.
- Functional incontinence: Physical disabilities, obstacles, or difficulty communicating your need to urinate prevents you from making it to the toilet on time.
- Transient incontinence: This temporary UI is the often the result of a short-term condition, such as a urinary tract infection. It may be a side effect of medication or other medical issue.
- Mixed Incontinence: Incontinence that falls into a two or more of the above categories.
Men and women experience very similar symptoms of UI. All symptoms point to an issue with bladder control and leakage.
Figuring out the underlying cause of UI symptoms can help you and your doctor begin treatment.
Conditions that commonly cause UI include:
- chronic cough
- bladder or urinary tract infections
- an obstruction in the urinary tract
- weak pelvic floor or bladder muscles
- loss of sphincter strength
- nerve damage
- enlarged prostate
- prostate cancer
- neurological disorders, which can interfere with bladder control signals
Other lifestyle factors that may lead to UI include:
- not being physical active
If you have one or more of these risk factors, you may be more likely to develop UI. These risk factors include:
Age: Men are more likely to develop UI as they grow older. This may be the result of physical changes that make holding urine more difficult. Certain diseases or conditions become more common with older age, and loss of bladder control may be an associated symptom.
Lack of physical activity: Being physically active may increase urine leakage, but not being physically active increases your risk for weight gain and decreases overall strength. This may make symptoms of UI worse.
Obesity: Extra weight on your midsection can place unnecessary pressure on your bladder.
History of certain conditions: Prostate cancer, an enlarged prostate, and treatments for these conditions can lead to temporary or permanent UI. Diabetes can also lead to UI.
Birth defects: You may experience UI if your urinary tract didn’t form correctly during fetal development.
A diagnosis for UI is relatively straightforward. Figuring out the underlying cause of UI may take more time. To get a diagnosis, your doctor will start by assessing your medical history. From there, additional tests may be needed. These include:
Physical exam: A physical exam can help your doctor identify problems.
Digital rectal exam: This exam helps your doctor find blockages in your rectum. It also helps him detect an enlarged prostate.
Diagnostic tests: Your doctor may take samples of your urine and blood to test for any underlying conditions.
Treatment for UI depends on the cause of the problem. Your treatment plan will likely include one or more lifestyle changes in addition to medication. In some cases, more advanced procedures or surgery may be necessary.
Fluid management: Timing food and drink consumption around your activities may help you better control your urge to go. Instead of drinking large amounts of water or other beverages at once, drink smaller amounts at regular intervals throughout the day.
Bladder training: Bladder training requires you to actively delay a trip to the toilet each time you get the urge. Your bladder and urinary tract should grow stronger.
Scheduling trips to the toilet may help you avoid urges. When you do go, urinating twice, once within a few minutes of the other, can help eliminate more urine.
Pelvic floor muscle strengthening exercises: These exercises are also known as Kegel exercises. They can help you rebuild strength and tighten muscles in your pelvis and urinary tract system.
Other lifestyle changes may include:
- Be more physically active. It can help you lose weight, prevent constipation, and reduce pressure on your bladder.
- Cut back on alcohol and caffeine. These substances can stimulate your bladder.
- Stop smoking.
Drugs and medications
Several types of medicine are used to treat UI.
- Anticholinergics, such as Oxybutynin (Ditropan), can calm overactive bladder muscles. They treat overactive bladders and urge incontinence.
- Alpha-blockers, such as tamsulosin (Flomax), is given for men who have and enlarged prostate. This can help men with urge or overflow incontinence to more fully empty their bladder.
- Mirabegron (Myrbetriq) can relax bladder muscles and help increase the amount of urine your bladder can hold. It can also help you more fully empty your bladder each time you urinate.
- Botulinum toxin type A (Botox) can be injected into your bladder to help ease bladder muscles.
During this procedure, a synthetic material is injected into the tissues around your urethra. This material will put pressure on your urethra and help it close when you’re not urinating.
Surgery is often a last resort treatment. Two surgeries are primarily used in men:
Artificial urinary sphincter (AUS) balloon: The balloon is inserted around the neck of your bladder. This helps shut off the urinary sphincter until it’s time to urinate. When you’re ready to urinate, a valve that’s placed under your skin deflates the balloon. Urine is released, and the balloon refills.
Sling procedure: Your doctor will use tissue or a synthetic material to create a supportive pouch around the bladder neck. This way, the urethra stays closed when you cough, sneeze, run, or laugh.
After surgery, most men recover in the hospital. This may take anywhere from several hours to several days. Many men are able to leave the hospital the same day as the procedure.
You should follow your doctor’s directions for healing and recovery. Don’t return to normal activity until your doctor has confirmed that it’s safe to do so. Your body needs time to heal from the surgery, and you need a few days to become accustomed to the results of the surgery.
Before you explore invasive surgery, your doctor might suggest a device that can reduce your symptoms and possibly prevent the need for surgery. This includes:
Catheters: A catheter may help you more fully empty your bladder. This thin, flexible tube is inserted through the urethra and into the bladder. The urine drains out, and the catheter is removed. An indwelling Foley catheter remains in place, but it can cause urinary tract infections.
Urinary collection systems: A condom catheter fits over the penis and collects urine that leaks out. It can only be used for a short time. Prolonged use increases your risk for urinary tract infections and skin irritation.
Underwear guards: Specially designed absorbent pads stick to your underwear to absorb urine. This product won’t stop the leaks, but it can help prevent any spots or wetness.
Urinary incontinence can interfere with many aspects of your life. Treatment for the underlying condition can ease these symptoms. Still, you may have concerns about certain aspects of your life.
Lifestyle concerns with UI include:
Physical activity: Exercising, gardening, and hiking are all rewarding physical pursuits, but if you have UI, they may seem daunting. Work with your doctor to gain confidence in your treatment plan and results, so you will feel comfortable pursuing your favorite activities.
Sexual activity: Some men and women with UI avoid sexual intercourse. You can still have sex, but you may need to take a few steps beforehand.
You may wish to:
- Avoid drinking caffeine or alcohol for several hours before sex.
- Avoid all liquids an hour before sex.
- Empty your bladder immediately before sex.
- Put a towel between you and your partner and the bed if you’re worried about leaks.
Be open with your partner. Communicating your concerns can help alleviate any anxiety you may feel.
It’s important that you talk with your doctor about any symptoms you’re experiencing and when they began. Bladder control problems are highly treatable. Together, the two of you can develop a treatment plan that helps you regain control of your bladder and preserve your quality of life.
Urinary incontinence may not be preventable. Risk factors, such as age and neurological conditions, are entirely out of your control.
However, lifestyle factors are controllable. Decreasing your risk for lifestyle factors that contribute to UI may help you prevent the condition. These measures include:
- Eat a balance diet, exercise often, and lose excess weight. All of these measures help reduce pressure on your bladder and contribute to better strength and health.
- Prevent constipation. Gastrointestinal issues, such as constipation, can increase your risk for UI. A healthy diet with plenty of fiber and regular exercise can help prevent constipation.
- Avoid irritating substances. Alcohol and caffeine can stimulate bladder activity, which may cause symptoms of UI over time.
- Strengthen pelvic floor muscles. There’s no harm in regularly performing Kegel exercises to keep pelvic floor muscles strong. This can help prevent UI in the future.