Urinary Incontinence is common and treatable

If you have urinary incontinence, you might feel embarrassed and alone, but you're not the only one. About one in four of us will have bladder control problems at some time – affecting 13% of men. The good news is that you don’t have to put up with it. Contrary to what a lot of men think, urinary incontinence is not a normal sign of ageing and it's not inevitable. It’s a treatable condition.

Types of incontinence

Stress incontinence results when laughing, coughing, sneezing or exercising puts pressure on the bladder and triggers leaking. It can occur after prostate surgery. Urge incontinence - caused by the bladder contracting when it shouldn't - triggers a sudden and overwhelming need to urinate. The feeling is so intense that it may be hard to make it to the toilet in time. Other types include overflow and mixed incontinence.

What causes male incontinence

Incontinence in men can result from medical conditions like enlarged prostate, diabetes and Parkinson's disease. It can be common after some types of surgery for prostate cancer or other surgery on the prostate gland. Sometimes it can develop for reasons we don't completely understand, like "overactive bladder." Understanding the cause is crucial to getting the right treatment, so it's important to get a diagnosis from your doctor.

How you can manage symptoms

Some men have success by spacing out their fluid intake during the day and cutting back a few hours before bedtime. If that helps, stick with it, but don't restrict yourself too much because you run the risk of getting dehydrated. When you're not drinking enough fluid your urine becomes concentrated - which can lead to complications such as bladder infections and make urinary incontinence worse.

Think before you drink

For some men, caffeine seems to irritate the bladder and worsen symptoms. Fizzy drinks can have the same effect. Alcohol is a diuretic - it makes you urinate more, which is really the last thing you need. Cut back on tea, coffee, fizzy drinks and alcohol and see if it makes a difference for you.

Adjusting your diet

Many men report that spicy or acidic foods can worsen urinary incontinence. Other common offenders seem to be chocolate and artificial sweeteners. However, the specific triggers vary from person to person. Some men find that diet doesn't seem to have any effect. To find out, try cutting back on common trigger foods for a week to see if it helps.

Reducing stress can help

Life with incontinence is stressful. Learning some simple relaxation techniques, like breathing exercises or meditation, may help control your symptoms. Biofeedback is another approach - you watch a monitor that gives you real-time information about muscle contractions around your bladder. With time you can learn how to relax your body, strengthen your muscles, and maybe get control of your male incontinence symptoms.

How to train your bladder

Try using behavioural techniques to control male incontinence, like bladder training. Start by going to the toilet every half an hour to urinate, whether you feel the urge or not. As you get into the rhythm, gradually - over days or weeks - expand the time between toilet breaks. Eventually, you may be able to space your breaks by three to four hours and the urges in between may decrease.

Track how often you urinate

To help find the cause of your male incontinence, try keeping a record of how much you drink and how often you urinate for a few days. Make note of any leaking, along with anything - drinking a lot, exercise - that might have triggered it. Then take the record to your doctor's appointment. It will help your GP better understand your symptoms and could provide more clues about the cause.

Flex your muscles

In men, pelvic floor exercises help treat incontinence by boosting the muscle strength around the bladder. Pelvic floor exercises are easy to fit into your daily routine. Start by finding the right muscle - it's the one you'd use to stop yourself from passing wind. Then just tense, hold and release. Slowly build up until you're doing three or four sets of ten of these each day. You can do them lying or standing - or even sitting at your desk.

Why incontinence pads help

Lots of men balk at the idea of getting pads or disposable pants. However, not only do they prevent the signs of a leak, they can protect your skin from irritation and block odour. Best of all, they can help you regain your confidence. You may be surprised at the number of options. Unlike the big, bulky "adult nappies" you might imagine, today's incontinence pads and pants are designed to be comfortable and not noticeable.

Pad and underwear options

Choosing the right product depends on your symptoms. For severe urinary incontinence, the ideal choice may be highly absorbent guards or disposable underwear. Pads can be tucked into your underwear and attached with adhesive tabs. They're designed for light to moderate leaking. Men with milder symptoms may need less. Drip collectors are disposable padded sheaths that go around the penis; they're good for slight leaking or dribbling. These pictures show options for different leakage severity.

Medications for male incontinence

For men with stress or urge incontinence, medication may help. Some block the nerve impulses to the bladder that make it contract at the wrong time. Others can reduce the muscle spasms that make the bladder contract. Other medications can slow down the production of urine. On the other hand, some medication can actually cause or worsen incontinence.

Incontinence surgery

Surgical options include a male sling for stress incontinence; material is inserted into the neck of the bladder to help support the urethra to prevent leaking due to coughing, sneezing or vigorous activities. An implanted artificial sphincter uses a cuff to close the urethra. Squeezing the pump deflates the cuff and releases urine when you want to urinate. A pacemaker-like device (shown above) stimulates nerves which relax the bladder and pelvic floor muscles.

Incontinence devices and products

External catheters roll onto the penis like a condom and catch urine. They're attached to drainage bags that can be hung over the side of your bed while you sleep or strapped to your body under your clothes during the day. Penile clamps and compression rings prevent leaks by gently closing off the urethra - and yes, they're more comfortable than they sound. Collagen injections - done as an outpatient procedure - can help bulk tissue around the neck of the bladder to prevent leakage.

Be prepared

Urinary incontinence can strike at amazingly inconvenient times. When you walk into a restaurant or shop, note where the toilets are so you can get there quickly. Planning a journey by car? Map out your route and decide on the spots where you'll take toilet breaks. Wear clothing that's easy to remove in a hurry. Always have extra pads and a plastic urinal in the car for emergencies.

Find support

Male urinary incontinence can be difficult. If you're relentlessly anxious about leaking, you can start to feel ground down. Your social life may suffer. You may not even want to leave the house. If this is what your life has become, do something. Look for a support group or therapist, or go back to the doctor and see if there's something else you can try. Remember: incontinence is almost always treatable.

Related Reading