Understanding male urinary incontinence

Stress urinary incontinence (SUI) occurs when physical movement or activity — such as coughing, laughing, sneezing, or heavy lifting — puts pressure or stress on a man’s bladder. SUI is not related to psychological stress. In men, the most common cause of stress urinary incontinence is the surgical removal of the prostate gland to treat prostate cancer. This procedure is called a prostatectomy.^1,2

Urge incontinence, also known as overactive bladder (OAB), is diagnosed when a man has an overwhelming need to urinate (gotta go, gotta go!) that may prevent reaching the toilet in time. Causes of overactive bladder include damage to the bladder’s nerves, damage to other parts of the nervous system, and damage to the muscles. Multiple sclerosis, Parkinson’s disease, diabetes, and stroke can affect nerves and lead to urge incontinence.^2,3

Mixed incontinence is present when a man suffers from symptoms of both stress urinary incontinence and urge incontinence. A man has mixed incontinence if he leaks urine when he sneezes, coughs, laughs, exercises, or lifts something heavy, AND leaks urine after a sudden urge to urinate, while he sleeps, after drinking water, or hearing or touching water. Mixed incontinence shares the causes of both SUI and urge incontinence.^2,4

Men suffering from bladder leakage may feel isolated and embarrassed. They may also feel like they are the only one facing this issue.

Approximately 9-16% of men have persistent post-prostatectomy leakage 1 year after treatment.⁶

Occasional leaks, wet pants, and a frequent or sudden need to urinate can happen at any age. Bladder leakage in men is usually caused by a damaged sphincter muscle or improperly functioning bladder (the sphincter is the circular muscle that controls urine flow out of the bladder). Short-term bladder leakage can also result from some medications or urinary tract infections. Incontinence due to nerve or muscle damage may cause longer-term leakage.⁷

Whatever the reason, incontinence can affect your self-image and your ability to enjoy life. If you have adjusted your life due to urine leakage, you may want to work with a urologist who specializes in bladder control.

With a thorough evaluation of your bladder leakage symptoms, your doctor may recommend changes to your daily routine, such as avoiding caffeine and alcohol. You may modify your fluid intake and follow a voiding schedule to try to train your bladder. Your physician may also recommend pelvic floor exercises to tighten the sphincter muscles.

If bladder leakage remains, some men cope by using absorbent pads and protective undergarments. Others use special devices to try to prevent urine leakage. If bladder leakage becomes a burden and affects your happiness, you can talk to a urologist specializing in male incontinence about options to restore bladder control.