Urinary incontinence in males

A brief about incontinence

Incontinence is a common problem occurring in males over 45-50 years of age. The patient loses normal control over urine passage and keeps voiding urine in small amounts in frequent intervals. Incontinence could be of any type depending upon the root cause and can result as overflow, urge, stress and functional incontinence.

 What are the pre disposing factors for incontinence?

•          Loss of bladder control due to spinal cord injuries.
•          Prostate gland enlargement.
•          Extensive infections of urinary tract.
•          Ageing problems causing brain disorders and mental confusions.
•          Neurological disorders like multiple sclerosis, Parkinsonism etc.
•          Tumors of brain and spinal cord.
•          Excess intoxication of alcohol.
•          Intake of certain medications which relax the bladder sphincter and cause urine loss.

What are the possible measures to be adopted for male incontinence?

NEMS: It is the neuromuscular electric stimulation of the muscles and nerves of pelvic floor. This can give good contractions to the bladder muscles and they are once again activated for active efforts. The patient is also asked to squeeze the urinary sphincter along with every wave of external stimulation to achieve maximum results.

Protective devices: These prevent wetting of clothes and include adult diapers, bed pads, drip collectors, and underwear liners. Penile clamps and external rings also stop the urine passage but along with these, it is important for a patient to follow a voiding schedule so that there is no obstruction or penile damage, swelling etc.

Bladder training: This begins with behavior therapy, patient’s cooperation and a voiding schedule. Patient is made frequently do the Kegel exercises, pass the urine from time to time and later an evaluation is done about his voiding and leakage of urine on day to day basis.

Biofeedback: This records and gives the patient a live feedback about his little efforts of squeezing the bladder. This is highly motivating and helps attain a urine control once again.

What is the pharmacological treatment for male incontinence?

The male incontinence treatment primarily includes medications before escalating to next level which is surgery. These medications are given to stop excessive bladder functioning or to improve overall bladder functions.

The anticholinergic agents have anti spasmodic qualities and decrease muscle spasms. These are preferred for urge urinary incontinence treatment.  The anti depressants block the improper nerve impulses and thus reduce spasms. The alpha 1 adrenergic blocking drug is especially given when there is benign prostatic hypertrophy which constantly compresses the urethral opening. Alpha reductase inhibitors slow down the male growth hormones which may cause BPH. 

Are there any side effects?

Dry mouth, dizziness, fatigue, erectile dysfunction, blurred vision are major side effects of drugs.

What is the surgical treatment?

The bladder pressure is reduced by injectible fillers first. Artificial urinary sphincter and resection of prostate gland are major surgical interventions to control urine output.

Preventive measures

Be active, exercise, quit smoking and avoid bladder irritants like alcohol, or caffeine.