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Urinary Incontinence -- Male

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by Randall B

(Incontinence, Urinary; Incontinence, Stress; Incontinence, Urge; Incontinence, Overflow; Incontinence, Functional; Stress Incontinence; Urge Incontinence; Overflow Incontinence; Functional Incontinence; Overactive Bladder)

 

Causes

The causes may vary with the type of incontinence.

Urge Incontinence

This is also known as overactive bladder. It may be caused by:

Overflow Incontinence

This occurs when the bladder will not empty. The urine builds up and overflows. This leads to leaking of urine. It may be caused by:
  • Prostate enlargement
  • Bladder that is blocked, such as by a scar in the urethra (stricture)
  • Fecal impaction putting pressure on the urethra
  • Drugs (such as antidepressants, hypnotics, antipsychotics, beta-blockers, antihistamines, calcium channel blockers)
  • Vitamin B12 deficiency
  • Weak bladder muscles
  • Nerve damage

Functional Incontinence

This is when you have normal bladder control, but you are physically unable to reach the toilet in time. It may be a result of a condition like severe arthritis. Drugs that cause confusion or sedation can also lead to functional incontinence.
There may be several different causes for incontinence. In some cases, the cause may also be unclear.
 

Risk Factors

Factors that may increase your risk of incontinence include:
 

Treatment

Treatments may include:

Behavioral Therapy

Behavioral therapy includes:
  • Making muscles stronger by doing Kegel exercises
    • These strengthen the muscles that hold the bladder in place and control urine flow.
    • Painless electrical stimulation is sometimes used. It can strengthen the muscles more quickly. It is helpful for stress incontinence.
  • Creating a regular schedule to empty your bladder (called bladder training). This training may also involve drinking fewer liquids

Weight Loss

Losing weight may help reduce the number of episodes due to stress or urge incontinence. Talk to your doctor about a weight loss program that is right for you.

Medication

Medicines may be prescribed to relax the bladder muscles. These types of medicines are called anticholinergics. They are often used in treating urge incontinence. Examples include:
  • Oxybutynin
  • Tolterodine
  • Darifenacin
  • Solifenacin
  • Fesoterodine

Devices

Absorbent diapers are often used by men with incontinence.
Catheters are sometimes used to treat more severe cases. External (condom) or internal (Foley) catheters may be used.
Another option is a penile clamp. These clamps are padded and have a sleeve to absorb leakage.
Condom Catheter
condom catheter
Copyright © Nucleus Medical Media, Inc.

Home Care

  • Take care of your skin by gently cleaning yourself after an episode of incontinence. Let the skin air dry.
  • Make it easier to get to the bathroom. For example, rearrange furniture and remove throw rugs. Add night-lights in the hallway and in the bathroom.
  • If needed, keep a bedpan or urine canister handy in your bedroom.

Nerve Stimulation

Devices like Urgent PC and Inter-Stim may be used to stimulate the nerves. This may involve implanting a thin lead wire with a small electrode tip. This electronic stimulation therapy can be done as a series of treatments in your doctor's office and can help strengthen musecles that control voiding.

Surgery

In men, surgery may be done to relieve a physical blockage due to an enlarged prostate.
Other procedures involve surgical repair or implants into the bladder sphincter. The sphincter is the gate that allows the urine to flow through.
 

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

Urology Care Foundation
http://www.urologyhealth.org

 

CANADIAN RESOURCES

Canadian Nurse Continence Advisors
http://www.cnca.ca

Health Canada
http://www.hc-sc.gc.ca

 

References


Corcos J, Gajewski J, et al. Canadian Urological Association guidelines on urinary incontinence. Can J Urol . 2006;13:3127-3138.


Incontinence. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143 . Updated January 2011. Accessed September 14, 2012.


Occhino J, Siegel S. Sacral nerve modulation in overactive bladder. Curr Urol Rep . 2010;11(5):348-352.


Prevention of incontinence. Continence Foundation website. Available at: http://www.continence-foundation.org.uk . Accessed September 14, 2012.


Subak L, Wing R, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med . 2009;360:481-490.


Urinary incontinence in men. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated June 29, 2012. Accessed September 14, 2012.


Urinary incontinence in men. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/uimen/#treated . Published June 29, 2012. Accessed September 14, 2012.


Wein A, ed. Campbell-Walsh Urology . 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.


Wein AJ, Rackley RR. Overactive bladder: a better understanding of pathophysiology, diagnosis, and management. J Urol . 2006;175:S5-10.


Yang C, Schwartz S, et al. A new, simple device to manage male urinary incontinence. International Continence Society website. Available at: http://www.icsoffice.org/publications/2005/pdf/0464.pdf. Accessed September 14, 2012.


12/3/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Cardozo L, Khullar V, Wang JT, Guan Z, Sand PK. Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement? BJU Int . 2010;106(6):816-821.

 

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