Incontinence in men: causes and treatment options
One in four men worldwide experiences urine leakage. But the good news is that incontinence is treatable. MyPelvi shows you how!
Katharina Heilen · 15 July 2024
One in four men worldwide experiences urine loss [1]. What may sound harmless has not only physical but also mental effects on those affected. Shame and social withdrawal are just two of them. But the good news is that incontinence is treatable. Because we understand how profoundly incontinence can affect your everyday life, ease and well-being, we show you all the options for getting incontinence under control.
What happens if a man can no longer hold urine?
When a man can no longer hold his urine, this is known as incontinence. However, there is more than one form of incontinence. Depending on the underlying cause, they are known as: 1.Stress incontinence (stress urinary incontinence) 2.Urinary incontinence (urge incontinence) 3.Mixed incontinence 4.Overflow incontinence 5.Functional incontinence 6.Reflex incontinence 7.Transient incontinence
1. Stress incontinence
Stress urinary incontinence, also known as stress incontinence, is a form of urinary incontinence in which you involuntarily leak urine when pressure on the bladder increases. This can happen, for example, during physical exertion, coughing, sneezing, laughing or other activities that increase what is known as intra-abdominal pressure. Stress incontinence often occurs when the muscles supporting the urethra and bladder (especially the pelvic floor muscles) are weakened. Causes of stress incontinence: Weakened pelvic floor muscles: Weak muscles, for example due to natural age-related muscle loss, may be unable to contract strongly enough to retain urine. Excess weight: Excess body weight can place additional pressure on the bladder and pelvic floor. Surgical procedures: Surgery in the pelvic area, such as a prostatectomy, can impair bladder support. Chronic cough: Persistent coughing, for example due to smoking or lung disease, can place excessive strain on the pelvic floor muscles.
2. Urge incontinence
Urge incontinence, also known as urinary urgency incontinence, is a form of urinary incontinence involving a sudden, strong urge to urinate that is difficult to control. If you have urge incontinence, you suddenly feel a very urgent need to go to the toilet. This often results in unintentional urine leakage. Causes of urge incontinence Overactive bladder: The bladder muscles contract suddenly and without warning, even when the bladder is not full. Neurological disorders: Conditions such as Parkinson's disease, multiple sclerosis, strokes or spinal cord injuries can affect the nerve pathways that control bladder function. Bladder infections: Urinary tract infections or cystitis can lead to urge incontinence. Bladder stones: These can irritate the bladder and cause a sudden urge to urinate. Medication: Some medications, such as diuretics, alpha blockers or antidepressants, can impair bladder function and lead to urge incontinence.
3. Mixed incontinence
Mixed incontinence is a form of urinary incontinence that presents symptoms of both stress incontinence and urge incontinence. This means that you lose urine during physical exertion (such as coughing, sneezing or exercise) while also experiencing a sudden, strong urge to urinate that is difficult to control. Causes Weak pelvic floor muscles: after prostate surgery or with increasing age, the pelvic floor muscles can become weaker. Overactive bladder muscles: the bladder muscles contract involuntarily, causing a sudden urge to urinate. Neurological conditions: conditions such as multiple sclerosis or stroke can impair bladder control. Bladder infections or inflammation: these can cause both urinary urgency and weakness of the pelvic floor muscles.
4. Overflow incontinence
Overflow incontinence is a form of urinary incontinence involving constant or recurring urine leakage. The reason: The bladder cannot empty completely. This leads to an uncontrolled, continuous flow of urine or frequent dribbling. Causes Bladder outlet obstruction: A blockage or narrowing of the urethra due to an enlarged prostate, urinary stones or – in rare cases – tumours can obstruct the flow of urine. Weak bladder muscles: Weak or damaged bladder muscles may prevent the bladder from contracting sufficiently to empty completely. Neurological conditions: Conditions such as multiple sclerosis, diabetes or spinal cord injuries can affect the nerve pathways that control bladder emptying. Medicines: Some medicines, such as opioids (e.g. morphine or codeine) or anticholinergics (e.g. to treat asthma or allergies), can impair bladder function and lead to overflow incontinence. Surgical procedures: Operations in the pelvic area, such as a prostatectomy, can damage the nerves or muscles that control bladder function.
5. Functional incontinence
Functional incontinence is when the person affected is theoretically physically and cognitively capable of controlling their bladder but does not reach the toilet in time due to external factors. This type of incontinence is not caused by dysfunction of the urinary tract itself, but by other causes that impair the ability to reach the toilet. Causes Cognitive impairments: conditions such as dementia or Alzheimer's can mean that a person does not realise that they need to go to the toilet or is unable to find the toilet in time. Restricted mobility: conditions that restrict physical movement, such as arthritis, walking disabilities, strokes or other physical impairments, can make it difficult to reach a toilet in time. Environmental factors: obstacles in the environment, such as an inaccessible toilet, long distances to the toilet or a lack of aids, can make it more difficult to reach the toilet. Medication: some medications, such as muscle relaxants, can impair awareness or mobility, making it difficult to get to a toilet in time.
6. Reflex incontinence
In reflex incontinence, the normal control mechanism for emptying the bladder is impaired, typically due to neurological damage. This type of incontinence occurs when your normal bladder-emptying reflex no longer works. Causes Spinal cord injuries: Damage to the spinal cord, e.g. due to accidental injuries or degenerative conditions, can impair the nerve pathways that control bladder emptying. Multiple sclerosis: This autoimmune condition can damage the myelin sheath of nerves in the spinal cord and brain, which can lead to dysfunction that also affects bladder control. Stroke: A stroke can affect parts of the brain responsible for regulating bladder function, which can lead to reflex incontinence. Neurological conditions: Other neurological conditions, such as Parkinson's disease, can also affect the nerve pathways that control bladder function.
7. Temporary incontinence
Temporary incontinence refers to a condition in which uncontrolled urine loss occurs temporarily. It is caused by a specific factor and disappears once the cause has been resolved. This type of incontinence generally occurs suddenly, without any previous signs of chronic bladder or nerve disease. Causes Urinary tract infections: A urinary tract infection can lead to increased urinary urgency and uncontrolled urine loss. Constipation: Constipation can increase pressure on the bladder and lead to uncontrolled urine loss. Alcohol consumption: Excessive alcohol consumption can temporarily impair bladder control. Surgery: Surgical procedures in the pelvic area can cause temporary bladder dysfunction that normalises over time. Stress or emotional strain: Stress and emotional strain can temporarily impair bladder control.
What does a urologist do for incontinence?
To treat incontinence, urologists examine your symptoms, your body and your urine to diagnose the cause of the incontinence and plan appropriate treatment. This includes the following aspects:
1. Medical history (patient interview)
The urologist will ask you some questions, such as: the frequency and amount of urinary incontinence situations where the incontinence occurs (e.g., during physical exertion) duration of symptoms any existing co-existing conditions (e.g., diabetes, neurological disorders) your medication intake lifestyle factors (e.g., fluid intake, caffeine and alcohol consumption)
2. Physical Examination
Your doctor will of course also examine your body, such as your abdomen and pelvis your bladder size and how full it is your pelvic floor
3. Urine analysis
A urine test can provide indications of infections, blood in the urine or other abnormalities. The following parameters are examined: Leukocytes (indication of infections) Erythrocytes (blood in the urine) Proteins and glucose (indication of kidney problems or diabetes)
4. Bladder diary
You may be asked to keep a bladder diary. In it, you will document your fluid intake, visits to the toilet and episodes of incontinence over several days. This helps identify patterns and better understand the type of incontinence.
5. Special tests and examinations
Depending on your medical history and examination results, urologists may perform specific tests, such as: Urodynamic tests: These measure bladder and urethral function, including bladder pressure and urine flow rate. Cystoscopy: A visual examination of the bladder and urethra using a thin, flexible endoscope. Ultrasound: An imaging procedure used to assess the kidneys, bladder and prostate. Post-void residual measurement: Determination of the amount of urine remaining after urination using ultrasound or catheterisation.
Sessions for incontinence in men
Have you noticed that you have incontinence? Don't worry! Many types of incontinence can be treated effectively. Depending on the diagnosis, the following measures can contribute to a significant improvement in symptoms.
Pelvic floor training
Your pelvic floor consists of muscles that surround and support the lower part of your pelvis, including the bladder and rectum. These muscles play a key role in controlling your urine flow. One of the most effective ways to strengthen your pelvic floor is through MyPelvi's 22-minute sessions. Using up to 25,000 magnetic pulses, the MyPelvi chair triggers muscle contractions that strengthen your pelvic floor muscles.
You are accompanied discreetly and with understanding by trained professionals to make the treatments as effective as possible. You do not have to do anything except sit back! The chair can be used while wearing everyday clothes and requires no effort on your part.
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Lifestyle and behavioural changes
Certain behaviours in your everyday life can help improve your incontinence. For example, losing weight can help relieve pressure on your bladder. Changing your fluid intake may also provide relief. Avoiding caffeine and alcohol, for example, is a good idea.
Medicines and surgical treatments
In severe cases and after consulting a doctor, medicines and surgical procedures may also be options for bringing incontinence back under control. The following options are available:
Sling surgery (sling operation): A sling is placed around the urethra to support it and reduce urine leakage. Artificial sphincter: An implanted device that closes the urethra when necessary. Bladder augmentation: Surgical enlargement of the bladder in cases of severe bladder weakness.
Can incontinence disappear again?
Don't worry! In many cases, incontinence can disappear again or at least improve considerably, depending on its cause and type. Surgery is rarely necessary; in many cases, however, strengthening the pelvic floor muscles (e.g. with MyPelvi) can already bring considerable relief.
The earlier incontinence is diagnosed and treated, the better the chances of improvement or recovery. Treatment should always be tailored to the individual's specific needs and causes. Be sure to seek medical advice if you notice signs of incontinence.
In many cases, a combination of medical treatment, exercises and lifestyle changes can improve incontinence. It is important to speak openly with doctors about the symptoms and follow the recommended therapy consistently.
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