What is Male Incontinence?
Diagnosed in nearly 1 in 10 men over 60, male incontinence is an inconvenient condition affecting men from all walks of life, through age groups and socio economic levels. Bladder control issues can affect men at any time in their life. At work, it can exacerbate stress and provide an unwelcome distraction. During home life, the burden this condition can play means men cannot enjoy longer timed activities, cannot be comfortable in locations where access to a close toilet is not guaranteed and it can distract from intimate activity and relationships as it can be a difficult topic to discuss with partners. Physical activity may also be limited due to time and space issues. Psychological distractions and the issue of stress urinary incontinence encouraged by physical activity may aggravate these unwanted symptoms.
Types of Incontinence
Men of all ages experience occasional sudden bladder control loss in their lives. To many liquids or alcoholic beverages, medication, damage to muscles and infections can all create bladder control deficiencies. These sporadic occurrences are not something to worry about. However, if you feel your life is beginning to be affected by continual problems with bladder control, you may have one or a combination of the following urinary issues. Whatever the cause, there is a solution to treat your problem and restore control and normalcy to your life.
- Stress urinary incontinence
This variation occurs when an everyday physical activity such as lifting shopping or picking up children places pressure on a man’s bladder, creating undesired bladder leakage. This condition is developed in those who have undergone the removal of the prostate gland due to cancer treatment.
- Urge incontinences
Also known as an Over Active Bladder, this condition means that men feel sudden or unplanned need to go to the bathroom with little warning, leading to bladder leakage before required. This condition is developed by nerve damage from other illnesses such as strokes, diabetes and Parkinson’s disease.
- Mixed incontinence
This condition combines both stress urinary incontinence and urge incontinence symptoms leading to both pressure from physical reactions such as sneezing with sudden urges to urinate after drinking or touching water. All 3 conditions have solutions to treat both the symptoms and the underlying conditions and can be addressed by our professional andrologists.
Modifying your fluid and alcohol intake along with a controlled urination schedule can help you to build control over your bladder and build mental confidence. Pelvic floor muscle activity to strengthen sphincter muscles and internal structures can also help to rebuild your physical confidence. If long term control issues continue to damage your confidence and lifestyle, talking to our experts and exploring their options will provide you with a considered medical plan to address your issues.
Readily available and easily changeable, absorbent pads or adult nappies provide the first line in urinary control. These products can be obtained at most pharmacies and produce a disposable or cleanable option. However, there is a stigma associated with these products and they can become expensive over time.
External Collection Devices
These catheter type bags can provide a comfortable option to collect leaking urine during physical day to day activity and at night. These can be discretely operated but can break or leak leading to anxiety and embarrassment.
This item can provide a physical blockage to prevent leakage through a hinged design. It can be a very effective tool for stress urinary incontinence and during activity and can be a reassuring mental support. The clamp does have to be regularly moved and the location varied in order to maintain control and not further damage to the penile musculature.
These surgically implanted devices work to support damaged musculature around the urethra and supporting muscles. A metal mesh is surgically implanted over the urethra and secured in place. The mesh works by compressing and elevating the urethra, allowing better intra-abdominal pressure transmission. The optimum tension is determined so the patient can find a balance between the adequate bladder levels and the feeling of bladder satisfaction. This method can be extremely successful in treating stress specific urinary conditions.
An extremely important treatment for patients who underwent prostate surgery, the Artificial Urinary Sphincter (AUS) is implanted in the male body and controls the urethra via a saline filled cuff. This maintains a closed urethra with a pump implanted in the scrotum used to encourage urination on demand. The AUS is inflated in the body to maintain control. When the patient wishes to urinate, he deflates the cuff via the pump. The AUS works for 90% of men who have undergone prostate removal to restore bladder control and confidence.
Frequently Asked Questions
IS STRESS URINARY INCONTINENCE (SUI) A PROBLEM FOR MEN? I THOUGHT IT ONLY AFFECTED WOMEN.
Both men and women can experience SUI, though it is more common in women. However, as many as 1 out of every 10 men experience urinary leakage at some time in their lives. For men, SUI is a common side effect of a urological procedure, pelvic trauma or condition affecting nerve functionality. Men may experience SUI after prostate cancer treatment and surgical treatment for an enlarged prostate (BPH). In addition, SUI can occur in patients with neurological conditions such as spina bifida.
HOW DO I KNOW IF I HAVE SUI?
When you leak any urine, you may have stress urinary incontinence (SUI). When SUI symptoms are mild, you may have leakage during rigorous activity such as playing sports or exercising, or when you sneeze, laugh, cough or lift something. If you have moderate or severe incontinence, you may leak urine even with low-impact movement such as standing up, walking or bending over.
IS SUI A SIDE EFFECT FROM TREATING OR REMOVING A PROSTATE?
Bladder leakage is one of the two most common side effects of radical prostatectomy; the other is erectile dysfunction (ED). If these side effects persist, there are successful treatment options available for both.
HOW LONG DOES SUI LAST FOLLOWING PROSTATE CANCER SURGERY?
SUI is usually resolved within the year following prostatectomy, but in some cases SUI can persist past a year without improvement. One study found that at one year following a robotic prostatectomy, approximately 1 in 10 men still have persistent stress urinary incontinence (SUI). Many men start managing their bladder leakage with products they can buy at pharmacies or grocery stores, such as pads and diapers. Other treatment options can come from your doctor, such as disposable condom catheters, penile clamps or intended permanent options such as a Male Sling System or an Artificial Urinary Sphincter [AUS]).
WHAT HAPPENS IF MY SUI LASTS LONGER THAN SIX MONTHS WITHOUT IMPROVEMENT? WHAT ARE MY OPTIONS?
If bladder control is still an issue 6 months after your procedure, you have persistent stress urinary incontinence and should see a specialist to discuss your treatment options. Make an appointment with a specialist who can help fix your incontinence.
DO THESE TREATMENT OPTIONS ALLOW ME TO RESUME A NORMAL LIFESTYLE?
Yes, most patients who receive either a male sling or AUS can resume normal activities such as playing golf, traveling, going out to dinner, or hiking without having to worry about unplanned bladder leakage. For some men, these treatments also allow them to play with their kids or grandkids without worrying about an accident. For many patients, these procedures allow them to return to living an active lifestyle.
SHOULD I THINK ABOUT A PROCEDURE TO FIX MY SUI?
Surgery is an option when behavioural or nonsurgical treatments don’t produce the results you want or need. The best step to take is to see a urologist who specializes in the treatment of incontinence to discuss the option that is right for you
HOW DOES A MALE SLING WORK?
The male sling works like a hammock to support the urethra providing normal bladder control for men. There is nothing to operate and it is completely concealed inside the body. In a recent study, 92% of patients who received the Sling said they would undergo the procedure again.
HOW DOES THE ARTIFICIAL URINARY SPHINCTER (AUS) WORK?
A urologist places the AUS in the body. It mimics a healthy urinary sphincter and closes off the urethra to prevent the loss of urine until it is time to void. When it is time to void, you squeeze the small pump in your scrotum, which opens up the cuff and allows urine to flow naturally. The whole system is completely concealed inside your body and is undetectable from the outside.
WHAT IS RECOVERY LIKE FOLLOWING A SURGICAL PROCEDURE FOR THE AUS?
Your urologist will manage your care immediately following your procedure and over the next several weeks. At the four- to six-week follow-up appointment, your urologist will activate the AUS and teach you how to use the AUS device.
HOW SATISFIED ARE PATIENTS WITH THE AUS?
The AUS implant has been available to patients for more than 40 years and is considered the gold standard treatment for SUI. In a recent study, 92% of patients would have the AUS implanted again and studies show that after the procedure, up to 90% of patients use one pad or less per day.
I am suffering from Incontinence, what should I do next?
If you believe you are suffering from a lack of bladder control and it causes you significant concern we advise you to see a specialist urologist/andrologist.
Our doctors have vast experience treating this condition and our clinic is an international referral centre for patients looking for treatment. We would be happy to review your case and treat you in our clinic.