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Urinary Incontinence

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Incontinence means the unintentional release of urine (also called leakage).  Leakage is common when muscles are “stressed” by sneezing, coughing, or bending over; this is called stress incontinence.  Some men experience urinary leakage during sexual intercourse.

There are many causes for incontinence, including Urinary Tract Infections, prostatitis, weakened pelvic floor or bladder muscles, conditions that affect nerve signals from the brain (such as diabetes, Parkinson’s disease, or stroke).  Men who have had radiation or surgical treatment for prostate cancer frequently experience incontinence.

Mild incontinence may be treated by controlling liquid intake, avoiding caffeine and alcohol, or wearing absorbent pads or underwear.  We highly recommend Depend Real Fit Incontinence Briefs for Men, which are comfortable, unobtrusive, and very absorbent.

Men can also increase their pelvic muscle strength and reduce incontinence by performing pelvic Kegel exercises.

If you’d like to try Kegel Exercises, get started by reading our article “Kegel Exercises for Men.”

Getting Medical Help

If leakage continues to occur, a urologist may recommend:

  • The use of certain drugs to reduce stress incontinence or treat an overactive bladder.
  • Botox injections into the bladder muscle causing the bladder to relax, increasing its storage capacity, and reducing episodes of leakage.
  • Surgical insertion of a mesh or sling to reposition and support the bladder1.
  • Surgical implanting a manually operated “valve” which is squeezed in order to urinate2.
  • Surgical insertion of small devices that electrically stimulate nerves that control the pelvic floor muscles.

New Treatment Options

There is some clinical evidence3 that Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT), which is currently used to treat erectile dysfunction and Peyronie’s disease, may also be an effective treatment for incontinence.


References

  1. Comiter, Craig V; Dobberfuhl, Amy D. “The artificial urinary sphincter and male sling for postprostatectomy incontinence: Which patient should get which procedure?” Investigative and Clinical Urology. Jan 2016. 57(1): 3–13. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778750/>
  2. Comiter, Craig V; Dobberfuhl, Amy D. “The artificial urinary sphincter and male sling for postprostatectomy incontinence: Which patient should get which procedure?” Investigative and Clinical Urology. Jan 2016. 57(1): 3–13. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778750/>
  3. Long, Cheng-Yu; Lin, Kun-Ling; Lee, Yung-Chin; Chuang, Shu-Mien; Lu, Jian-He; Wu, Bin-Nan; Chueh, Kuang-Shun; Ker, Chin-Ru; Shen, Mei-Chen; Juan, Yung-Shun. “Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence.” Nature Scientific Reports. April 2020. 10, Article number: 5818 (2020).
    <https://www.nature.com/articles/s41598-020-62471-4>

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