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MALE URINARY INCONTINENCE

Male urinary incontinence is a health problem that can affect men's quality of life. Our network of expert urological surgeons will explain male urinary incontinence in detail, including its symptoms, causes, physical and psychological consequences, and the various treatment options available.

What are the symptoms of male urinary incontinence?

Male urinary incontinence is characterised by the involuntary loss of urine in men, which can have a significant impact on quality of life.

Symptoms can vary depending on the type of incontinence, which includes stress incontinence, urge incontinence, mixed incontinence and others.

Stress incontinence

Urge incontinence

Mixed incontinence

Others

When urine leakage occurs due to an increase in abdominal pressure, such as when laughing, sneezing or exerting physical effort.

is characterised by a sudden urge to urinate, followed by involuntary leakage. Leakage occurs before reaching the toilet.

is a combination of stress incontinence and urge incontinence. Leakage can occur when there is an increase in abdominal pressure or when there is a sudden need to urinate.

- Nocturnal incontinence in adults,

- Overflow incontinence due to urinary retention,

- Functional incontinence due to physical problems such as reduced mobility.

What causes male urinary incontinence?

The causes of male urinary incontinence can be varied and may include factors such as:

Prostate Problems

1. Benign prostatic hyperplasia (BPH)
It is a non-cancerous increase in the size of the prostate gland, common with age. The enlarged prostate can compress the urethra, disrupting the normal flow of urine and causing symptoms such as stress incontinence or overflow incontinence.
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2. Prostate cancer and treatments
- Prostatectomy: Surgical removal of the prostate can damage the nerves and muscles of the urinary sphincter, which is responsible for bladder control.
- Radiotherapy: Can cause inflammation of the bladder and urethra, leading to temporary or permanent urinary incontinence.

Neurological disorders

1. Neurodegenerative diseases
These conditions can disrupt communication between the brain and the bladder, leading to urge or overflow incontinence. (ex: Multiple sclerosis, Parkinson's disease)
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2. Spinal Cord Injury
- Consequences: Can interrupt nerve signals essential for bladder control.

Side effects of medicines

Some medicines, particularly those used to treat BPH, diuretics, certain antidepressants and sedatives or other urological conditions, can cause or worsen incontinence.

These can either increase urine production or relax the bladder sphincter.

Obesity and Lifestyle

1. Obesity
Excess weight increases pressure on the bladder and pelvic floor, exacerbating stress incontinence.
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2. Smoking and alcohol
Can irritate the bladder and increase the risk of incontinence.

Other Potential Causes

1. Urinary Tract Infections
This can cause temporary urge incontinence.
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2.Chronic Constipation:
The pressure of a full rectum on the bladder can contribute to incontinence.

What are physical and psychological consequences of male urinary incontinence?

Male urinary incontinence can have a significant impact on quality of life.
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- Physical consequences can include: skin irritation, recurrent urinary tract infections and reduced self-esteem.
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- Psychologically, it can lead to: depression, anxiety and relationship problems. It is essential to recognise the psychological impact of this condition.

How to treat male urinary incontinence?

Male urinary incontinence can be embarrassing, but there are many treatment, solutions and management options to help alleviate the symptoms. Options vary depending on the cause and severity of the incontinence. Here are some of the common treatment, solutions and management options for male incontinence:

Perineal rehabilitation: Kegel exercises to strengthen the pelvic floor muscles can help improve urinary control. A healthcare professional can teach you how to do them correctly.
Medication: some medications can help manage the symptoms of male urinary incontinence.
Weight management: For overweight men, weight loss can reduce pressure on the bladder and improve urinary control.
Nappies and pads: for short-term management, products such as adult nappies, anatomical pads or absorbent underwear are available.
Medical devices:‍

Light urinary incontinence

Sub-urethral slings
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It is a surgical device used to treat light incontinence in men.
It prevents leakage during effort.
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More Information

Moderate to severe urinary incontinence

Artificial Urinary Sphincter
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It can be used to control moderate to severe incontinence.
Placed around the urethra, the device mimics the function of the natural urinary sphincter.

More Information

It is important to consult a urologist surgeon for an accurate diagnosis and recommendations on the most appropriate treatment options for your situation. Treatment options may vary depending on the cause of the incontinence, whether it is stress incontinence, urge incontinence or another form of urinary incontinence.

About artificial urinary sphincter surgery

Artificial urinary sphincter surgery is a treatment option for moderate to severe male urinary incontinence, particularly stress incontinence, which does not respond to other forms of treatment. The procedure involves the implantation of a special medical device to restore bladder control in men.

What is the process for having an artificial urinary sphincter implantation?

Artificial urinary sphincter surgery is a treatment option for moderate to severe male urinary incontinence, particularly stress incontinence or mixed incontinence, which does not respond to other forms of treatment. The procedure involves the implantation of a special medical device to restore bladder control in men.

Preparation: A detailed medical assessment is carried out to determine whether the patient is a suitable candidate for this procedure. Medical history, symptoms and diagnostic test results are taken into account.
Anaesthesia: Artificial urinary sphincter surgery is usually performed under spinal or general anaesthetic.
Implantation of the artificial urinary sphincter: During surgery, the surgeon places an artificial urinary sphincter around the urethra. The device consists of two main components: a pump and a cuff. With ZSI device, no material in the pelvis.
How the artificial urinary sphincter works? The artificial sphincter is designed to keep the urethra closed at all times, preventing unwanted urine leakage. To empty the bladder, the patient manually activates the implanted pump, which releases the fluid from the inflatable cuff and opens the urethra to allow urine to flow.
Urinary incontinence control: The device allows the patient to regain a degree of control over urination, thereby reducing urine leakage. It also offers the possibility of emptying the bladder in a more normal way.‍

What are the benefits of artificial urinary sphincter surgery for men?

Effectiveness: This procedure is generally very effective in treating moderate to severe incontinence in men, including stress incontinence.
Improved quality of life: For men with severe incontinence, the urinary sphincter device can significantly improve their quality of life by reducing or eliminating urine leakage and no more stress.

What are the risks and considerations after artificial urinary sphincter implantation?

Infection: As with any surgical procedure, there is a risk of infection.
Erosion: The cuff squeeze gently the urethra but an urethral erosion may occur.