Stress Incontinence Archives

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.

Incontinence is a medical condition usually referring to the loss of urinary continence, the ability of a person to control the flow of urine. This condition is a symptom of an underlying problem in the urinary or the genital system that affects thousands of people everywhere each year.  More people suffer from stress incontinence than from any other types of urinary incontinence and more women experience this at some point in their lives.

With stress incontinence, urine loss happens when greater pressure is applied by the abdominal muscles on the bladder during movements such as coughing, sneezing or lifting. Along with weak pelvic floor muscles and loose urethral sphincter, control over urine flow is lost. There are different reasons for the occurrence of stress incontinence in women. More common of which are:

  • Pregnancy and childbirth.  Women of child-bearing age are more susceptible to losing muscle tone on the pelvic floor due to the baby’s weight and straining during childbirth. Trauma to the tissues during medically assisted deliveries contribute to the loss of muscle strength
  • Menstruation causes the pelvic floor muscles to relax to allow blood to flow freely.  When this happens, urine may leak at the same time menstrual blood does
  • Premenopausal and post-menopausal syndrome contributes to the changes in the bladder muscles and the underlying tissues and organs. Lowered Oestrogen hormones reduces strength of the bladder walls and elasticity of the urethral sphincter leading to leaks and dribbles

Studies have shown that light stress incontinence can be treated with a pelvic floor workout called the Kegel exercise. This set of exercises aims to strengthen the muscles cradling the bladder, uterus and the bowels.  In more severe cases, Kegels may not be enough to correct the problem. In some instances, a combination of different treatments may be needed.

Although surgery may be considered to correct a physical injury as in the case of a torn tissue, this is a procedure not without disadvantages.  More women prefer the less invasive procedure of the incontinence sling where incision is minimal and can be done as an out-patient in a doctor’s clinic. Recovery period is fast with laparoscopic procedure and cure rate is as high as 85%-95%.

A sling procedure is the insertion of a fine ribbon mesh made of synthetic material or from the person’s own tissue and wrapped around the urethra. The tape’s end is sutured into the pubic bone to form a “hammock” and ease the pressure coming from the drooping bladder. The doctor makes tiny incisions in the lower abdomen for the insertions and navigation is done through an endoscope.

It is best to discuss the options with your doctor and know the risks involved. Depending on the attending physician’s advice and the patient’s preferred sling procedure, there are currently three most common procedures favoured by many patients and surgeons alike for its higher success rate:

  • Trans Vaginal Tape (TVT) is a tension-free sling made of polypropylene material that is inserted underneath the urethra through two tiny incisions to provide support and improve control over urine flow. This is a fairly safe procedure and cure rate is about 85%. However, there are rare cases of  secondary complications due to accidental bladder perforation  during surgery
  • Trans Obturator Tape (TOT) eliminates the retro pubic needle entry to avoid unnecessary complications. The mesh tape is inserted underneath the urethra through the three small incisions in the groin area
  • The Mini-Sling is a more advanced sling procedure developed in the US that was designed to reduce the risk factors reported in the other two procedures. Insertion of the mesh tape into the internal obturator muscle is through a single vaginal incision

For post-menopausal urinary incontinence, a sling procedure may be the best option to treat stress incontinence along with the other treatments for a more successful regimen. Incontinence sling has been developed to help women live a more productive life and help manage the inconvenience of having a “leaky” bladder.  Consult your doctor and be informed.

While the effects of stress incontinence are felt by millions of people, a disproportionately high number of women experience it compared to men. After understanding the symptoms and causes of stress incontinence, this inequity is no mystery.

In a case of stress incontinence, urine is involuntarily released when even slight pressure is placed on the bladder. Typical actions that cause stress incontinence include laughing, sneezing, coughing, or straining to lift a heavy object. These place a sudden increase in pressure on the abdominal area around the bladder, which results in stress incontinence.

The Effect on Women

Stress incontinence occurs because the muscle charged with holding urine in the bladder, known as the sphincter, is weak or damaged. Likewise, the pelvic floor muscles hold up the bladder and surrounding tissue, so when these muscles are not strong, the bladder and urethra can shift out of place, keeping them from functioning properly.

One of the main contributors to this condition is pregnancy and childbirth. The rigors of childbirth can cause damage to internal organs such as the muscles of the pelvic floor, delicate nerve endings, the urethra, and the bladder itself. If there are complications during the birthing process, the likelihood of postpartum stress incontinence increases. The types of complications that can increase the chance of muscle damage include a forceps delivery, a long labor, a large baby, and a massive episiotomy.

At any given time roughly one third of women in the UK, across all age groups, suffer from some symptom of incontinence. This number is so high because of the toll that pregnancy and childbirth take on a woman’s body.

Unfortunately there is still a good deal of embarrassment that accompanies incontinence, and as a result, many women deal with stress incontinence privately for years before seeking the help of a physician. It is important for women to understand that incontinence is neither a natural byproduct of childbirth or of aging, and if episodes of stress incontinence are occurring regularly, it is important to consult with a physician. The good news is that more often than not incontinence can be cured, and even if treatment options do not completely resolve the problem, symptoms can be managed.

Identifying the Problem

While stress incontinence is the most common type suffered by women (especially those under 40), there are also other types of incontinence that women may experience. It is important to let a medical professional properly diagnose any incontinence as it occurs. Often doctors will perform a physical exam to determine your overall health, and collect a urine sample to rule out a urinary tract or bladder infection.

Typically a physician asks a series of questions regarding when the incontinence problems started; when symptoms are most pronounced; if there is any pain or other accompanying symptoms; how often episodes of incontinence occur; if any drugs are being taken; and if there is any constipation. The doctor may also ask additional questions, including some about eating and drinking patterns. Therefore, it may be useful to keep a log of your diet along with bathroom visits and episodes of incontinence.

After making a determination of what is causing the incontinence, a physician will recommend a course of treatment to cure the incontinence, or at least minimize its effects. The solution can be as simple as adjusting your diet, or it may be as involved as surgery, with lots of options like exercise, medications, or bladder training in between.

If you suffer from stress incontinence, take heart: you are not alone! Discuss it with your physician to find a solution to bring it under control.

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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