Male Incontinence

Factors that contribute to an increased risk of developing urinary incontinence include:

• Advanced age
• Obesity
• Cigarette smoking
• Kidney disease
• Diabetes

Incontinence can be caused by multiple factors including lifestyle habits, physical problems and medical conditions. Causes of temporary and persistent urinary incontinence include:

• Bladder irritation caused by infection, dietary irritants or stones
• Urinary tract infections
• Medications
• Diseases and disorders of the nervous system
• Pelvic surgery
• Diabetes
• Delirium
• Overactive bladder
• Weakness of certain muscles in the pelvis
• Weakness of the tissues holding the bladder in place
• Weakness of the sphincter muscles surrounding the urethra
• Birth defects
• Spinal cord injuries
• Enlarged prostate
• Prostate surgery

Symptoms associated with incontinence in men include:

• Needing to rush to the restroom and/or losing urine
• Abnormal urination or changes in urination related to a nervous system problem
• Leakage of urine that prevents activities
• Leakage of urine that began or continued after surgery
• Leakage of urine that causes embarrassment

Some men with urinary incontinence experience minor leaks of urine while others frequently wet their clothes. The following are types of incontinence:

• Stress urinary incontinence is leakage that occurs with activities that increase abdominal pressure such as coughing, sneezing, lifting, jumping and running.
• Urgency incontinence or overactive bladder is a sudden, strong urge to urinate that cannot be controlled.
• Mixed urinary incontinence is a combination of urge and stress incontinence.
• Overflow urinary incontinence happens when the bladder does not empty and the urine amount exceeds the bladder’s capacity. Frequent urination and leaking results.

Diagnosing incontinence in its earlier stages can lower the risk of developing future problems and relieve bothersome symptoms. Your urologist may complete the following diagnostic tests:

• Medical history
• Physical exam
• Urinalysis
• Cough stress test
• Cystoscopy enables a urologist to view the inside of the bladder and urethra via a thin tube.
• Fluoroscopy, a radiological technique for visually examining the bladder
• Urodynamics tests help your doctor or nurse see how well your bladder and sphincter muscles work.
• Voiding diary

Treatment for stress incontinence may include:

• Non-Surgical
  • Behavioral modification
  • Weight loss
  • Quitting smoking
  • Dietary changes
  • Pelvic floor rehabilitation (To learn more about Kegel exercises, please click here for a printer-friendly information guide)
  • Biofeedback/Electrical stimulation
  • Medications
• Surgical
  • Urethral Injection is a minimally invasive surgical procedure done under local anesthesia that uses a cystoscope and small needle to close the urethral mucosa.
  • Injection of Botox into the wall of the bladder through a cystoscope to reduce urgency, frequency and urge incontinence.
  • Placement of a male sling increases the resistance within the urethra to minimize or eliminate stress urinary incontinence.
  • Placement of an artificial urinary sphincter.

Treatment for urgency incontinence may include:

• Botox injection
• Behavior modification
• Pelvic floor rehabilitation
• Fluid intake management
• Medications
• Neuromodulation

Treatment for overflow incontinence may involve:

• Medication or surgery to remove possible obstruction
• Self-catheterization

An easy prevention technique is to learn and practice pelvic floor exercises at a young age, before the onset of urinary incontinence. It is recommended that men experiencing mild symptoms be evaluated by a BWH urologist. Early treatment will prevent serious future problems.

You will receive a thorough diagnostic examination and receive treatment by a board-certified urologist who specializes in male incontinence. Our goal is to alleviate or eliminate symptoms so you can return to everyday life.

Brigham and Women’s Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your incontinence, you will be referred to an appropriate BWH physician for an evaluation.