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Urinary incontinence is the accidental leaking of urine. It's not a disease. It's a symptom of a problem with a man's urinary tract.
Urine is made by the kidneys and stored in a sac made of muscle, called the urinary bladder. A tube called the urethra leads from the bladder through the prostate and penis to the outside of the body. Around this tube is a ring of muscles called the urinary sphincter. As the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.
When you have to urinate, the nerve signals tell the muscles in the walls of the bladder to squeeze. This forces urine out of the bladder and into the urethra. At the same time the bladder squeezes, the urethra relaxes. This allows urine to pass through the urethra and out of the body.
Incontinence can happen for many reasons:
Urinary incontinence happens more often in older men than in young men. But it's not just a normal part of aging.
Urinary incontinence can be short-term or long-lasting (chronic). Short-term incontinence is often caused by other health problems or treatments. This topic is about the different types of chronic urinary incontinence:
Different types of incontinence have different causes.
In men, incontinence is often related to prostate problems or treatments.
Drinking alcohol can make urinary incontinence worse. Taking prescription or over-the-counter drugs such as diuretics, antidepressants, sedatives, narcotics, or nonprescription cold and diet medicines can also affect your symptoms.
Your doctor will do a physical exam, ask questions about your symptoms and past health, and test your urine. Often this is enough to help the doctor find the cause of the incontinence. You may need other tests if the leaking is caused by more than one problem or if the cause is unclear.
Treatments depend on the type of incontinence you have and how much it affects your life. Your treatment may include medicines, simple exercises, or both. A few men need surgery, but most don't.
There are also some things you can do at home. In many cases, these lifestyle changes can be enough to control incontinence.
If you have symptoms of urinary incontinence, don't be embarrassed to tell your doctor. Most people with incontinence can be helped or cured.
Learning about urinary incontinence:
Living with urinary incontinence:
Health Tools help you make wise health decisions or take action to improve your health.
Urinary incontinence occurs when the bladder's sphincter muscle is not strong enough to hold back the urine. This may happen when:
Prostate treatment is a major cause of urinary incontinence in men.
The bladder contractions that cause urge incontinence can be caused by many conditions, including:
Overflow incontinence is usually caused by blockage of the urethra from BPH or prostate cancer. Other causes include:
You can have one or more types of incontinence. Each type may have a different cause.
Your symptoms depend on the type of urinary incontinence you have.
The main symptom of stress incontinence is the leaking of urine when you cough, laugh, lift, strain, or change posture.
Symptoms of urge incontinence may include:
Symptoms of overflow incontinence may include:
Urinary incontinence is often related to prostate problems. As men age, the prostate gland grows larger. It can squeeze the urethra and push the neck of the bladder out of position. These changes can lead to incontinence.
In most cases, incontinence caused by an enlarged prostate can be cured by medicine or prostate surgery.
If your incontinence is not related to prostate surgery and it appears suddenly, it will usually clear up after you get treatment for whatever is causing it. For example, incontinence related to a urinary tract infection, prostatitis, or constipation will most likely disappear when the infection or condition is cured.
Many things have been linked to an increased risk of urinary incontinence in men.
See your doctor right away if your urinary incontinence does not go away or you also have:
Call your doctor if:
Don't be embarrassed to discuss incontinence with your doctor. It is not something that always happens with aging. Most people with incontinence can be helped or cured.
If you have a sudden change in your ability to urinate and you are not sure if it is related to your urinary incontinence, see the topic Urinary Problems and Injuries, Age 12 and Older.
If you have chronic urinary incontinence that begins slowly, you may be able to control the problem yourself. If home treatment doesn't control your problem, or if incontinence bothers you, ask your doctor about treatment.
If you have incontinence that begins suddenly (acute), call your doctor. Acute incontinence is often caused by urinary tract problems or medicines. It can be easily corrected.
Any of the following health professionals can diagnose and treat urinary incontinence:
If you need surgery to treat your incontinence, make sure to find a surgeon who is experienced in the type of surgery you need, usually a urologist.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
To learn the cause of your urinary incontinence, your doctor will first review your medical history and give you a physical exam. Along with routine testing, such as a urinalysis, this may be all your doctor needs to diagnose the cause and start treatment.
Your doctor may ask you to keep a voiding log. This is a record of the amount of liquids you drink and how much and how often you urinate.
Tests that may be done to find the type and cause of your urinary incontinence include:
Your doctor may do a cystoscopic exam. This is a test that allows your doctor to see inside the urinary tract.
You may need more tests if:
Some tests aren't often used for incontinence, but they may be helpful. One example is cystourethrogram. It's an X-ray of your bladder and urethra while you are urinating.
If your doctor wants to do more tests, ask how the test can help your doctor treat your incontinence.
The treatment you and your doctor choose depends on your type of urinary incontinence and how bad your symptoms are.
If there is no infection or cancer or other cause that could only be cured by surgery, treatment is done in stages.
Many men who have urge incontinence or overflow incontinence also have an enlarged prostate gland (benign prostatic hyperplasia, or BPH). For more information, see the topic Benign Prostatic Hyperplasia (BPH).
Exercise is important for your physical and emotional health. Even if being active causes some leakage, get regular exercise. It can help you manage stress and keep your muscles in tone.
Continence products absorb urine or apply pressure to keep urine from leaking. To learn more, see Other Treatment.
You may reduce your chances of developing urinary incontinence by:
You can use behavioral strategies to help control urinary incontinence. These include simple changes to your diet, lifestyle, and urinary habits.
Try one or more of these tips. They may help you gain some control over your symptoms:
Talk with your doctor about all the medicines you take, including nonprescription medicines, to see if any of them may be making your incontinence worse. Medicines that may cause urinary incontinence in men include certain antidepressants, sedatives, and even some allergy and cold medicines.
Medicine can help with some types of urinary incontinence.
Some medicines that are used to treat incontinence may actually make it worse in men whose incontinence is caused by an enlarged prostate gland (benign prostatic hyperplasia, or BPH). So consulting with a urologist is an important part of incontinence care.
Surgery may be an option for men who:
Overflow incontinence caused by an enlarged prostate (benign prostatic hyperplasia, or BPH) is the form of incontinence most often treated with surgery. For more information about surgery options and treatment for BPH, see the topic Benign Prostatic Hyperplasia (BPH).
Stress incontinence caused by removal of the prostate gland may also be treated with surgery if the incontinence isn't cured after a period of watchful waiting.
Surgery for severe stress incontinence that does not improve with behavioral methods includes:
Surgery works for some people and not others. It is most likely to improve incontinence when:
Things that can lead to disappointing results include:
Treatment other than surgery or medicine may be used to treat urinary incontinence.
Behavioral therapies, including biofeedback and pelvic muscle exercises, are used to treat urge and stress incontinence.
Products such as absorbent pads or diapers, incontinence clamps, or pressure cuffs may be used to manage any form of incontinence. Some of these products absorb leaked urine. Others put pressure on the urethra to help prevent urine from leaking.
CitationsMacDiarmid SA, et al. (2008). Efficacy and safety of extended-release oxybutynin in combination with tamsulosin for treatment of lower urinary tract symptoms in men: Randomized, double-blind, placebo-controlled study. Mayo Clinic Proceedings, 83(9): 1002–1010. Kaplan SA, et al. (2006). Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder. JAMA, 296(19): 2319–2328. Other Works Consulted Chapple CR, Milson I (2012). Urinary incontinence and pelvic prolapse: Epidemiology and pathophysiology. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 1871–1895. Philadelphia: Saunders. Herschorn S (2012). Injection therapy for urinary incontinence. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2168–2185. Philadelphia: Saunders. Naumann M, et al. (2008). Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1707–1714. Resnick, NM (2012). Incontinence. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 110–114. Philadelphia: Saunders. Silva LA, et al. (2011). Surgery for stress urinary incontinence due to presumed sphincter deficiency after prostate surgery. Cochrane Database of Systematic Reviews (4). Wadie BS (2010). Retropubic bulbourethral sling for post-prostatectomy male incontinence: 2-year followup. Journal of Urology, 184(6): 2446–2451.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerAvery L. Seifert, MD - Urology
Current as ofSeptember 9, 2014
Current as of: September 9, 2014
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Avery L. Seifert, MD - Urology
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