Incontinence & Overactive Bladder Health Center
Related to Incontinence & Overactive Bladder (OAB)
Prostate and Incontinence
Treatments for Incontinence & Overactive Bladder (OAB)
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Incontinence in Men

Incontinence (leakage of urine) is not just a women's problem.
There are thousands of men that have bladder control problems.

5–7% of men under 64 years of age have urinary incontinence.
10–20% of men over 64 years of age have urinary incontinence.

In men, incontinence can take various forms.
  • The most common type of incontinence in men
is urge incontinence, meaning you have to rush to the toilet
(urgency) and may leak along the way (urge incontinence).
You might experience this more often in cold weather or with
hearing the sound of running water. Or, you might also notice
dribbling after you have passed urine. Although more common
in older men, young men can have theses symptoms.The
problem is often related to a blockage at the outlet of the bladder, caused by
enlargement of the prostate gland benign prostatic hypertrophy (BPH).
  • Some men have had bladder problems all their lives, such as bedwetting, urgency, urge incontinence or having to pass urine frequently.
  • Difficulty in holding urine sometimes results from a previous prostate operation, especially when you cough, sneeze, during exercise or standing (stress incontinence). This is common directly after an operation, but often improves within weeks.

Why does an enlarged prostate cause incontinence?
Enlargement of the prostate gland tends to occur with aging. Approximatley 40% of men that are 60 years of age have enlarged prostates. That percentage rises to about 75% by the age of 80. The reason is not known, but it is not related to cancer.

An adult prostate is about the size of a chestnut and weighs 20–25gm. In benign prostatic hypertrophy (BPH), the size of the prosate can increase to 60gm or more. As it expands, the prostate wraps itself round the neck of the bladder like a collar, restricting the outlet, and the bladder muscle has to work harder to push the urine out.

  • Because of the obstruction, you notice that your stream is weak or starting a steam is difficult or that urine seems to flow, then stops and starts one or more times..
  • The strain makes the bladder muscle misbehave so that it often starts to contract before the bladder is full, causing urgency. Because the bladder tends to contract before it is full, you will pass urine frequently in small amounts and may have to get up more often during the night to pass urine.
  • The bladder has difficulty in emptying completely, because the outlet is restricted, and there is always some urine left inside. Gradually, more and more urine is left inside and, in severe cases, eventually overflows without any feeling of urgency. This is called overflow incontinence.

What you can do
Try to work out if your prostate is enlarged. If you can answer yes to any of the following questions, it is quite likely that you have an enlarged prostate.

  • Do you have difficulty in starting to pass urine?
  • Do you think it takes you too long to pass urine?
  • Do you pass urine in stops and starts?
  • Do you dribble urine without full control when you have tried to stop?
  • Do you have a sensation of not having emptied your bladder completely?
  • Do you have to get up more than twice a night to pass urine, but only pass small amounts?

If you do think that your prostate may be enlarged, then you should arrange to see your doctor to check that this is the cause of your symptoms. If the problem is really troubling you, your doctor may decide to try medication. A drug (finasteride) is available to shrink the prostate, but when you stop taking it the prostate starts to grow again. Other drugs (alpha-blockers) relax the bladder neck and the prostate itself, but have side effects in some people. You may need a prostatectomy operation to remove the enlarged prostate.

Decide whether urgency is your main symptom. If you have urgency, you could try ‘bladder retraining’. Some men find this helps, but generally it is not as effective in men as in women. Discuss the problem with your doctor, because there are various medicines that are very effective in calming an overactive bladder.

Dribbling after passing urine. If you dribble after passing urine, try running your finger along the underside of your penis to force out any remaining liquid.

Even if your incontinence cannot be cured completely, there are great products
on the market that are very absorbent and will help you be protected and active.

After a prostate operation. Tell your doctor if you have incontinence after a prostate operation that has not improved within a few weeks. Pelvic floor exercises often help, especially if a Continence Nurse Specialist shows you how to do them properly. Various operations might be possible, such as insertion of a sling to support the exit tube from the bladder, or an implanted device to replace the inadequate neck of the bladder.