What are the other Names for this Condition? (Also known as/Synonyms)

• Bladder Incontinence in Men
• Lack of Bladder Control in Men
• Uncontrollable Urination in Men

What is Urinary Incontinence in Men? (Definition/Background Information)

• Urination is a voluntary reflex that is under the control of an individual. Incontinence occurs, when certain problems are encountered by the muscles that help in holding and releasing urine
• Urine is stored in the bladder, which is connected to the urethra - the tube through which it is released out of the body
• When an individual urinates, the muscles in the walls of the urinary bladder contracts. This allows the urine to be discharged out of the bladder, into the urethra. The sphincter muscles around the urethra relax, allowing the urine to pass out of the body
• An individual with urinary incontinence is unable to control this reflex mechanism. The condition is also known as involuntary urination
• Urinary Incontinence in Men is generally observed in elderly men, who are at an increased risk of developing this condition
• Smoking, obesity, and prostate gland problems, are few of the risk factors associated with Urinary Incontinence in Men
• The signs and symptoms depend upon the type of incontinence. But, generally involuntary leakage of urine while laughing or coughing, and a sudden urge to pass urine, are a few of the common sign and symptoms associated with it
• The diagnosis of Urinary Incontinence in Men require a physical examination with thorough evaluation of the individual’s medical history, and a few specific tests that include urine analysis (UA), pelvic ultrasound, and urodynamic studies
• The treatment of urinary incontinence ranges from behavioral techniques and lifestyle modifications, to the use of certain medications and various surgical options, which are tried when initial techniques prove ineffective
• Urinary incontinence can be appropriately managed with  lifestyle changes/adjustments, and medications, while surgery may be required in a few cases

The different types of Urinary Incontinence in Men are:

• Stress incontinence
• Urge incontinence
• Overflow incontinence
• Mixed incontinence

Who gets Urinary Incontinence in Men? (Age and Sex Distribution)

• Men of all ages and race may be affected by urinary incontinence
• Elderly men have an increased risk of developing this condition

What are the Risk Factors for Urinary Incontinence in Men? (Predisposing Factors)

The risk factors associated with Urinary Incontinence in Men are:

• Men with prostate gland problems have an increased risk of urge and overflow urinary incontinence
• Advancing age: As an individual grows older, the bladder muscles and urethra lose their strength and the individual is at a high risk for urinary incontinence
• Obesity: Being overweight increases the pressure on the bladder, which in-turn increases the risk
• Smoking: Smoking initiates coughs and chronic coughing can increase the risk of urinary incontinence. Smoking also puts pressure on the bladder and leads to its over-activity, thus increasing the risk
• Other diseases, like kidney disease and diabetes, could make individuals more susceptible to the condition
• Family history and genetic factors may be risk factors for stress incontinence
• Disability: When an individual suffers from brain and spinal cord disorders, there is a higher risk for urinary incontinence
• Prostatectomy: Risk of urinary incontinence is increased, when a surgery is performed to remove the prostate gland

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Urinary Incontinence in Men? (Etiology)

The possible causal factors for Urinary Incontinence in Men are:

• Alcohol consumption: Alcohol activates the bladder; it is also an agent that increases the amount of urine excreted, which can in-turn be the cause for urinary incontinence
• Caffeine: It activates the bladder and it is also an agent that increases the amount of urine excreted
• Bladder irritation: Certain foods make the bladder work more, and these include -
  • Carbonated water
  • Tea and coffee
  • Sugar, artificial sweeteners
  • Corn syrup
  • Food with high spice content
• Medications: Certain medications can cause bladder control problems and these include medications taken for -
  • Heart conditions
  • Blood pressure
  • Muscle relaxants
  • Sedatives
• Certain medical conditions may also be responsible for causing temporary urinary incontinence, which include:
  • Urinary tract infection
  • Constipation

Some of the causes for persistent Urinary Incontinence in Men are as follows:

• Changes with age: As a person grows older, the bladder muscles become weaker and loses its efficiency/resilience, which could be a reason for urinary incontinence
• Painful bladder syndrome or interstitial cystitis, a condition which may lead to frequent urination
• Prostatitis: Inflammation or swelling of the prostate glands (which are located right below the male bladder)
• Benign prostatic hyperplasia (BPH): A condition which is marked by enlargement of the prostate gland, could be a possible cause
• Prostate cancer: Urinary incontinence may be caused as a side effect of treating prostate cancer
• Bladder cancer: Bladder cancer could also lead to urinary incontinence
• Bladder stones: Stones in the bladder may be a reason for acquired urinary incontinence
• Neurological disorders affect the signals passed by the nerves in controlling bladder functions
• Obstruction: Any swelling, lump, or abnormal growth, in the urinary tract may affect the free flow of urine from the bladder
• Weakness of the bladder muscle
• Overactive bladder muscles
• Damage to the urethral sphincter
• When the stomach faces extra pressure
• A nerve problem persisting right after birth
• Spinal cord injury

What are the Signs and Symptoms of Urinary Incontinence in Men?

The signs and symptoms associated with Urinary Incontinence in Men depend upon the type of urinary incontinence:

Symptoms for stress incontinence include loss of urine, during:

• Coughing
• Laughing
• Lifting (slightly heavy objects)
• Straining, while changing posture

Symptoms of urge continence:

• A sudden urge to urinate
• Unexpected accidents
• Urge to urinate very often, mostly at night

Symptoms of overflow incontinence:

• Release of some urine accidentally, often without an urge to urinate
• Urine stream is very weak
• Straining while urinating
• Spontaneous urination, while being asleep
• May or may not sense that the bladder is full

How is Urinary Incontinence in Men Diagnosed?

The diagnosis of Urinary Incontinence in Men is made on the basis of a physical examination, medical history evaluation, and certain diagnostic tests.

• To determine the cause of the disease, the physical examination may include:
  • Examination of the urinary system
  • Examination of the nervous system
• Evaluation of medical history may include the risk factors associated with the disease. A previous history of similar episodes may be present or confirmed
• Patients are also asked to maintain a diary, which consists of information on their bladder habits, such as the amount of liquids (water) taken, number of times they urinate, the amount of urine excreted, etc.

Other diagnostic testing tools for Urinary Incontinence in Men may include:

• Urinalysis (UA): A urine sample is sent to the lab to check for infection, presence of blood, kidney functions, and other abnormalities
• Blood test: A blood sample is sent to the lab to check for the causes of incontinence
• Post void residual (PVR) measurement: The patient is asked to urinate and the physician then observes how much urine is left behind in the bladder, using an ultrasound test. The amount of leftover urine in the bladder will give information about some blockage in the urinary tract, or may indicate other problems in the bladder nerves and muscles
• Pelvic ultrasound: The urinary tract and genitals are observed for abnormalities
• Stress test: The patient is asked to cough and the healthcare provider will then observe for any loss of urine
• Urodynamic tests - various measurements may be made using this test, like:
  • Capacity and volume of the bladder
  • Pressure, which the bladder exerts
  • Maximum pressure, which the sphincter muscles can bear
  • Speed with which the bladder is emptied
  • Co-ordination between the sphincter and bladder muscles
• Cystogram: A catheter is introduced into the bladder and urethra, through which a fluid containing a special dye is injected. When the individual urinates, images show up on x-rays, which brings out any abnormalities in the urinary tract
• Cystoscopy, to examine the urinary bladder: A thin tube with light source and a camera at its end is passed into the bladder, through the urethra, in order to detect any structural abnormalities or abnormal growth

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Urinary Incontinence in Men?

Various complications of long-standing Urinary Incontinence in Men may include:

• Skin complications, such as skin rashes, sores and infections, due to constant wetting of the skin as a result of urine leakage 
• Infections of the urinary tract: Untreated urinary incontinence may lead to repetitive urinary tract infections
• Difficulty living, performing regular/daily activities: Urinary incontinence may become a cause of social embarrassment, leading to anxiety and depression. It may hamper the individual’s capacity to work, play, exercise, and perform routine activities. It may also cause distress, while having sex

How is Urinary Incontinence in Men Treated?

The treatment of Urinary Incontinence in Men depends upon the type of incontinence, its severity, and underlying causes. Initially, least invasive treatment methods are tried; other options are considered, if these methods fail.

Behavioral techniques:

• Bladder training: Based on the facts and observations recorded in the bladder diary, the physician shall fix a pattern to toilet usage, at certain set/regular intervals. This will help in training the patient gain control over the bladder
• Double voiding: This technique involves urinating, then waiting awhile and then urinating again. It will help in emptying the bladder completely, thus avoiding overflow incontinence
• Life style modifications: Reducing liquid consumption; limiting the intake of caffeine, alcohol, and acidic foods; losing weight; and increasing physical activity may also be beneficial

Pelvic floor exercises or kegal exercises are especially effective for stress incontinence, but may also help in urge incontinence. These exercises help in making the pelvic muscles become stronger, which helps the bladder hold back urine.

Medications:

• Anticholinergics are given to control overactive bladder in cases of urge incontinence
• Discontinuation of the medications that cause urinary incontinence

Electrical stimulation: Gentle electrical stimulation by electrodes temporarily placed in the rectum and vagina, to stimulate and strengthen the pelvic floor muscles. This technique is effective in cases of stress and urges incontinence

Nerve stimulation:

• Sacral nerve stimulator:
  • The stimulator looks like a pacemaker and controls bladder function
  • It is kept under the skin of the buttock
  • The sacral nerve is connected to the device/stimulator, through a wire
  • Painless electrical pulses passing through the wire stimulate the nerves
• Tibial nerve stimulator:
  • This is used to control the symptoms occurring due to an overactive bladder
  • Electrodes are placed underneath the skin
  • Electrical pulses pass through this electrode on to the tibial nerve in the ankle
  • This electrical pulse then travels to the sacral nerve and controls the overactive bladder

Surgery: 

• Artificial sphincter: This artificial device is implanted (instilled) inside the body, which will help in keeping the urethra closed, until the patient is ready to urinate
• Male sling: In this method a support is created for the urethra by wrapping a strip of material around it and attaching the other end to the pelvic bone. This sling puts pressure on the urethra and does not allow it to open, until the patient consciously wills to urinate. The various types of slings used are:
  • Tension free
  • Adjustable
  • Conventional
• Urinary diversion: A reservoir is created by removing a piece of small intestine and diverting the ureters to the reservoir. An opening in the lower abdomen is also made, so that the urine can drain out through a catheter, or drain into a bag
• Bladder neck suspension: This provides support to the urethra and bladder neck

Devices: Men, who continue to experience urinary incontinence, need to find a management solution that matches their individual situation.

• Collecting system: A sheath is worn over the penis funneling the urine into a bag, which is worn on the leg
• Absorbent products, such as special undergarments, protective underwear, underpants, and adult diapers
• Fixer-occluder incontinence device: A device that is strapped around the penis, softly pressing the urethra, to stop the flow of urine

How can Urinary Incontinence in Men be Prevented?

The risk of Urinary Incontinence in Men can be reduced by following preventative and precautionary measures, such as:

• Maintaining an appropriate body weight, which reduces the pressure on the bladder
• Smoking cessation: Smoking leads to persistent coughing, which in turn puts pressure on the bladder muscles, leading to urinary incontinence
• Avoiding drinks and food that contain substances, which may irritate the bladder, like caffeine
• A fiber-rich diet is helpful in eliminating constipation, which is also considered a cause of urinary incontinence
• Limiting alcohol intake

What is the Prognosis of Urinary Incontinence in Men? (Outcomes/Resolutions)

• The prognosis of Urinary Incontinence in Men depends on the cause of the condition
• Urinary incontinence can be appropriately managed with medications and lifestyle changes/adjustment
• Surgery is curative in some cases

Additional and Relevant Useful Information for Urinary Incontinence in Men:

• Urinary incontinence may also affect women of all ages; however, the causal factors may vary

The following article link will help you understand urinary incontinence in women.

http://www.dovemed.com/diseases-conditions/urinary-incontinence-in-women/