Male Incontinence: Common Causes and Solutions

Incontinence is defined as inability to control urination. It is estimated that approximately 423 million people worldwide experience some form of urinary incontinence.* Urinary incontinence occurs in women twice as often as in men, but male urinary incontinence is still relatively common.**

Many adult men experience occasional urinary leakage or dribbling; if it becomes a regular issue, it may be a sign of incontinence. In this article we will touch upon the difference types of incontinence men experience as well as common condition and lifestyle factors that can lead to it.

What causes male incontinence

Several factors can contribute to male incontinence, including:

  • Prostate problems (benign prostatic hyperplasia, prostate cancer)

  • Prostate surgery

  • Neurological diseases such as Parkinson’s and multiple sclerosis

  • Lifestyle factors such as obesity, smoking and alcohol consumption

  • Certain medications such as diuretics and blood pressure medications

Causes of male incontinence vary and it’s important to see a healthcare professional to evaluate what might be causing the problem in each individual case. Treatment will depend on the type of incontinence as well as the underlying condition causing it.

Types of urinary incontinence

Some of the most common types of male urinary incontinence are:

Stress urinary incontinence (SUI)

Involuntary urine leakage when you sneeze, cough or exercise are typical signs of stress incontinence. These sudden movements or outbursts put pressure on the bladder and urethral sphincter. In short, stress incontinence can be the result of a weak urethral sphincter muscle. Your urethral sphincter usually prevents urine from leaving your bladder. If it's weakened, you'll likely experience urine leakage whenever there's too much pressure on the sphincter muscle.

Typically, men experience stress incontinence due to sphincter or nerve trauma related to prostate surgery. Stress urinary incontinence is often treated with pelvic floor exercises and rehab, surgical interventions, or containment pads and products.  Talk to your healthcare professional about the options best for your individual symptoms.

Urge urinary incontinence (UUI)

Overactive bladder (OAB) and urge incontinence are in fact the same thing.  They both are defined by symptoms only.  The patient complains of urinary urgency, frequency, with and without dribbling of urine or complete bladder emptying before reaching the toilet.  These symptoms negatively impact daily activities, sleeping, and social interactions. Some of these men actually have involuntary contractions of the bladder muscle resulting in the same symptoms as mentioned.  However, when the healthcare professional tests the bladder and finds actual involuntary contractions of the bladder it is now called detrusor overactivity.

Mixed incontinence

Mixed incontinence is a combination of stress incontinence and urge incontinence, and experienced when sneezing, coughing or exercising.

Overflow incontinence

Men with overflow incontinence often experience symptoms similar to stress incontinence.  However, the cause of overflow leakage is related to incomplete bladder emptying either due to bladder obstruction or weak bladder contraction strength.  Imagine a bucket filled to the top with water, and each time you move it, water spills over the top.  When the bladder is consistently overfilled, you can experience leakage with movement, coughing, sneezing, laughing, and leaning forward, for example.  Ask your HCP about bladder testing to establish the cause for overflow incontinence.

Functional incontinence

Functional incontinence means losing control of your bladder, usually due to another medical condition that prevents you from reaching the toilet in time. You may experience smaller leakages or dribbles or at times fully empty your bladder involuntarily. Some of the conditions that may cause functional incontinence include:

  • Cognitive disorders that affect your brain's ability to process thoughts and take action, including dementia, delirium and intellectual disabilities

  • Conditions that affect your brain, spinal cord or nerve signals (neurological disorders), including multiple sclerosis and Parkinson's disease

  • Conditions that affect your muscles and make it hard or impossible to get to the bathroom or remove clothing, like severe arthritis

Male Urinary Incontinence Treatment

Maintaining a healthy weight and watching your diet can help relieve symptoms of urinary incontinence

Speak with your healthcare professional if you are experiencing urinary incontinence; it's only normal to search for ways to control urination as it can feel very invasive and be a stress factor in daily life.

Remember to always consult with your doctor to find the right solution for your urinary problems, as they can carry out a physical exam and also take your medical history into account, which is important for any diagnosis.

  1. Pelvic floor exercises (also called Kegel exercises): Strengthening your pelvic floor muscles is an efficient and non-invasive method to help regain continence. Kegel exercises are considered a very effective treatment when it comes to urinary incontinence, and doesn't require any equipment. Go to our section on Kegel exercises to learn how to perform Kegel exercises and train your pelvic floor.

  2. Bladder training: Bladder training involves training your bladder muscles and can include scheduled and systemized toilet visits as well as double voiding to ensure complete bladder emptying every time you urinate. Maintaining a bladder diary can be a helpful supplement to this training.

  3. Lifestyle & diet: Your weight can play an important part in managing urinary incontinence. An unhealthy diet and excess weight is an increased risk to developing urinary incontinence or make urinary incontinence worse due to excess pressure on the bladder. Maintain a healthy weight to minimize risk. Certain foods and drinks can irritate the bladder and should be avoided if you suffer from urinary incontinence. Avoid acidic foods and eliminate or minimize your intake of alcoholic beverages or beverages containing caffeine such as tea, coffee, energy drinks or soda.

  4. Surgery: Severe urinary incontinence or chronic urinary incontinence may require surgery. A common type of surgery is replacing a damaged or weakened sphincter with an artificial sphincter to control urine flow. Male sling procedures are another type of surgery to treat incontinence in men. This type of surgery involves placing an artificial sling to tighten the urethra.

Incontinence products for men

Only a trained healthcare professional can recommend male incontinence solutions that are right for your specific situation.

Frequently used male incontinence products include the following solutions:

  • Absorbents

  • Protective underwear

  • Incontinence pads

  • Male external catheters

  • Urine bags

The best product for male incontinence depends on the type of incontinence you're experiencing, what's available where you live and your preferences.

Where can I get more advice about male urinary incontinence?

Your healthcare professional is the best place to go for advice if you experience urinary incontinence. It might seem embarrassing to discuss your incontinence but healthcare professionals are trained to manage and discuss intimate problems and will have seen many men with incontinence. Your healthcare professional will be able to identify the type of incontinence that affects you and if necessary refer you to a urology clinic or continence specialist.

*Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011 Oct;108(7):1132-8. [PubMed]

**Managing acute and chronic urinary incontinence. AHCPR Urinary Incontinence in Adults Guideline Update Panel. Am Fam Physician. 1996 Oct;54(5):1661-72. [PubMed]

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