What is urinary incontinence in men?
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:
• If your bladder squeezes at the wrong time, or if it squeezes too hard, urine may leak out.
• If the muscles around the urethra are damaged or weak, urine can leak out even if you don't have a problem with your bladder squeezing at the wrong time.
• If your bladder doesn't empty when it should, you are left with too much urine in the bladder. If the bladder gets too full, urine will leak out when you don't want it to.
• If something is blocking your urethra, urine can build up in the bladder. This can cause leaking.
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:
• Stress incontinence means that you leak urine when you sneeze, cough, laugh, lift something, change position, or do something that puts stress or strain on your bladder.
• Urge incontinence is an urge to urinate that's so strong that you can't make it to the toilet in time. It also happens when your bladder squeezes when it shouldn't. This can happen even when you have only a small amount of urine in your bladder. Overactive bladder is a kind of urge incontinence. But not everyone with an overactive bladder leaks urine.
• Overflow incontinence means that you have the urge to urinate, but you can release only a small amount. Since your bladder doesn't empty as it should, it then leaks urine later.
• Total incontinence means that you are always leaking urine. It happens when the sphincter muscle no longer works.
• Functional incontinence means that you can't make it to the bathroom in time to urinate. This is usually because something got in your way or you were not able to walk there on your own.
Different types of incontinence have different causes.
• Stress incontinence can happen when the prostate gland is removed. If there has been damage to the nerves or to the sphincter, the lower part of the bladder may not have enough support. Keeping urine in the bladder is then up to the sphincter alone.
• Urge incontinence is caused by bladder muscles that squeeze so hard that the sphincter can't hold back the urine. This causes a very strong urge to urinate.
• Overflow incontinence can be caused by something blocking the urethra, which leads to urine building up in the bladder. This is often caused by an enlarged prostate gland or a narrow urethra. It may also happen because of weak bladder muscles.
Urinary inconsistency condition in male can be diagnosed using several methods.
• Digital rectal examination is done to check for the enlargement of the prostate.
• Other method is abdominal ultrasonography and pelvic ultrasonography, which can identify the presence of external factors that cause the compression of the bladder.
• Urodynamics is another method for identifying the incontinence of the stress.
Apart from these diagnostic methods, a dairy has to be maintained by the candidate to count how many times one has to go to washroom for relief. It helps as an indicator of incontinence
The urinary incontinence can be cured in different methods. The selection of the method and time needed for the treatment varies from one candidate to the other.
Behavioral modification involves sufficient training for bladder and timed voiding. It gives the training for the intake of the fluid, before going to bed and before going to out for parties or car trip, etc. Such training helps avoiding the accidents, while sleeping or while being outside. Timed voiding also involves the training for emptying bladder in regular intervals. The behavioral modification is effective for the candidates suffering from the mechanical bladder compression and also an overflow incontinence.
Different medicine is given for different purposes. Certain medicine is given to relax the bladder and its surrounding muscles so that full emptying is allowed. It is done usually with alpha blockers. Some other medicine can be used for the reduction of the hormone levels so that the prostate enlargement of the prostate also can be reduced. The mechanical pressure over the bladder is reduced, easing the flow of the urine
Kegal exercise is the strengthening of the floor muscles of the pelvic. The exercise can tighten the sphincter muscles and makes the outlet of the bladder to be closed, while performing strenuous activities. To perform this exercise, pull the pelvic muscle and continue to hold until, counting 3. Relax after counting 3. Repeat the same exercise for 3 sets and repeat 10 times. However, we should not overdo it. Kegal exercise is possible with biofeedback. It helps relieving from the stress incontinence.
There are surgeries conducted for severe conditions of male urinary incontinence.
Urinary leakage in the male candidates can be treated with the artificial sphineter. This device is an implanted device helps keeping the urethra be closed, until the candidate gets ready for urination. The artificial sphineter device is helpful for the urinary incontinence that is caused from nerve damage interfering the function of the sphincter muscle or weakened muscle function. If the inconsistency is because of the uncontrolled bladder contractions, it does not solve the problem.
Artificial sphineter surgery is performed with spinal or general anaesthesia. The device consists of three parts, a cuff, a small balloon and a pump. The cuff is fit around the urethra, the balloon acts as a reservoir, which is kept in the abdomen and the pump is kept in the scrotum. When the cuff is filled with the water, it is fit around the urethra tightly and prevents the leakage of the urine. Before the urination, the pump has to be squeezed with the finger so that the cuff is deflated and the liquid starts moving the balloon reservoir. Then the urine starts flowing the urethra. After the bladder is made empty, the cuff will be refilled in the following 2 to 5 minutes, automatically so that the urethra will again be tightly closed.
Urinary diversion surgery is considered if the function of the bladder is lost because of the damage of the nerve or the bladder has to be removed. The surgery provides a urinary diversion. During the surgery, a reservoir is created after removing a small intestine piece and the ureter is directed to this reservoir. A stoma is also created as an opening for the lower abdomen so that the urine can be drained towards the bag through a catheter.
Male sling surgery procedure provides the support by wrapping a strip over the urethra. The ends of the strip are then attached to pelvic bone ends. The sling continues to keep the pressure over the urethra until the urine is released consciously by the candidate.
You may want to ask some questions before your treatment begins: