Incontinence in Men Archives

Man incontinence

It is not unusual for men to experience urinary incontinence. Prostatectomy is one cause, but men who suffer incontinence following a radical prostatectomy do not necessarily have to undergo further surgery to correct this distressing post-surgical complication.

It may be that patients and their physicians are not allowing enough time for the restoration of continence. Korean researchers studied 708 men who had undergone a radical prostatectomy and found that approximately 10% of patients failed to regain continence a year after surgery; however, 56% of these patients regained continence within 54 months. The average time of recovery of continence was 15 months. Although there are no standard guidelines as to when to intervene surgically when incontinence is an issue after a radical prostatectomy, this study shows that it may take longer than a year for some men to regain control of urination.

What factors did the researchers find influenced recovery of bladder control? Age and severity of incontinence were both found to be important factors in determining the likelihood of a return to normal function. Men who were younger at the time of surgery and who needed to use only a single incontinence pad per day were most likely to recover function, while older men who used more than one pad were less likely to regain control of their bladders. In addition, length of the membranous urethra and shape of the prostate were also found to be influencing factors.

This study may prove useful to patients and their physicians when a year has passed after radical prostatectomy and bladder function is still an issue. Rather than another surgery, tincture of time may be all that is needed for some of these patients.

Although stress urinary incontinence (SUI) is traditionally thought of as a female problem, it is actually not uncommon to come across a man who suffers from male stress incontinence.

The mechanism behind the stress incontinence in both sexes is the same: a weakness in the ring of muscles surrounding the opening of the bladder. When the pressure in the pelvis around the bladder increases, due to straining, this ring of muscles, called the sphincter, gives way and lets a variable amount of urine leak.

What Causes Male Stress Incontinence?

The commonest cause of male stress incontinence is damage of the sphincter muscles during the removal of the prostate, a male gland which wraps around the tube carrying the urine from the bladder to the outside.

The prostate gland is removed either because it enlarges and compresses the flow of urine, or because it has a malignant tumor in it. Procedures aimed to treat benign prostatic enlargement are many such as TRUP (Trans Urethral resection of Prostate) and prostatectomy (removal of prostate). While these may cause stress incontinence, it still is a rare occurrence.

Malignant tumors (cancers) necessitate a surgery known as radical prostatectomy, where the whole of the prostate is removed along with some neighboring tissue (the seminal vesicles). Radical prostatectomy is commonly followed by male stress incontinence. In fact, as much as 90% of patients complain developing incontinence after radical prostatectomy. The good news is, most of these complaints will be only temporarily.

Can Male Stress Incontinence Be Treated?
Pelvic floor muscle exercises are the mainstay of treatment in male stress incontinence. These exercises, also known as Kegel’s exercises, are aimed at strengthening the bladder’s sphincter and therefore allowing it to seal off the bladder better.

Male stress incontinence, like its female counterpart,  can be greatly improved through strengthening the sphincter muscles: the ring-like fibers looping around the exit of the urinary bladder.

Sphincter muscles are part of a group called the pelvic floor muscles. Strengthening the pelvic floor reflects positively on the strength of the sphincter and greatly improves stress incontinence.  It is estimated that anywhere between five and twenty five percent of men who suffer from post-prostatectomy stress incontinence (stress incontinence after prostate surgery) will show marked improvement within four to six weeks after the procedure.

Dealing with Male Stress Incontinence
Suffering from male stress incontinence does not have to reduce the quality of your life. There are a variety of measures you can adopt in order to live life fully, unhindered by the occasional leaks you suffer from:

  • Visit your doctor and talk to them about your symptoms. They are the best judge on whether or not you need to alter your lifestyle or medication regimen to reduce he urinary leaks.
  • Be diligent with your pelvic floor exercises, even if at first you see no improvement.  These usually take effect in six to eight months time.
  • Do wear protective incontinence products designed to absorb the leaked urine and save you from embarrassment. You may start with cup shaped pads specific to fit the male’s body and move on to more absorbent products if you feel you need more protection.
  • If you are reluctant or feel embarrassed about shopping for incontinence pads you can get them online and have them discreetly delivered to your door step.

Dealing with incontinence can be a very distressing experience for anyone, and when faced with this challenge, it is important to understand how the urinary excretory system is supposed to work to help better understand what occurs with incontinence in men. The overall picture of the excretory system is pretty straightforward, and it involves only four main body organs. The bladder and urethra are where most problems leading to incontinence in men occur, and they are at the end of the urinary excretory process. At the beginning of the process are the kidneys and ureters.

The kidneys are brilliant at filtering out any toxins, excess fluids and salt from the bloodstream, and the waste is neatly packaged in the form of urine that is moved from the kidneys to the urethra for efficient removal from the body. The first organs to get busy cleaning the bloodstream are the kidneys, and they are charged with keeping the chemical elements in the bloodstream balanced. Whether it is the acid base or salt to water ratio the kidneys help to regulate the blood’s chemistry. Along with maintaining the proper chemical balances in the blood, the kidneys are also essential for pulling waste from the blood, and as a matter of fact the filtration systems that the kidneys provide are so important, that at least one kidney is necessary for survival.

At the bottom of each kidney is a ureter, and together they work like drains for the kidneys. The ureters are instrumental in moving the urine that is produced in the kidneys along to the bladder. Each ureter is a long, narrow tube, which measures about 25 cm. The muscles along the walls of the ureter help to constantly deliver urine from the kidneys to the bladder.

Upon entering the bladder, urine can only move in one direction, and when the bladder is about one third full, nerve endings signal the brain that it will need to empty soon. The male bladder is almost twice as large as a female’s bladder holding 800 ml or so of urine, and it is able to hold the urine for about twice as long as a female’s bladder. There are two sphincter muscles that release urine from the bladder. One is involuntary, and the other is voluntary. Nerve endings will trigger the relaxation of the involuntary sphincter, while the voluntary sphincter can be trained to tense and relax at will. The muscles that control the urine flow from the bladder surround the urethra and are known as the urethral sphincter. When the urethral sphincter is relaxed, urine flows freely from the bladder into the urethra for excretion..

The bladder muscle itself is extremely pliable. It is supported by the pelvic floor muscles, and it is tucked neatly between the pubic bone and the rectum. When urine leaves the bladder, it exits the body through the urethra, which is about 18 cm in length in a man. Since a male’s urethra is so much longer than a woman’s, and because their bladder is capable of holding more urine for longer periods of time, it only stands to reason that men also have much stronger sphincter muscles than women.

Surrounding the urethra, men have a prostate gland, and as it enlarges with age, it is one of the prime contributors to incontinence in men. Of course, there are many other underlying causes for incontinence in men, like injury, illness or genetics, but an enlarged prostate gland exerting undue pressure on the urethra is one of the most common complaints leading to incontinence in men.

Disclaimer: All material published on the Incontinence.co.uk web site is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. The information is not intended to replace medical advice offered by your doctor or health professional. Readers should always discuss health matters and review the information carefully with their doctor or health care professional. Extended Disclaimer
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