What is Urinary Incontinence?
Urinary incontinence is the inability to control the outflow of urine from the bladder. This can occur during a variety of situations and for various reasons, but is commonly experienced during periods of exertion to the abdomen or “stress” such as lifting, coughing, laughing, and sneezing.
In general, urinary incontinence impacts the sufferer’s quality of life negatively and can also affect friends and family. Treatment options will depend upon an individual’s condition, which will include consideration of the information below.
On this page you will find information on:
Anatomy of the Male Urinary Tract
This illustration depicts the key features of the male urinary tract necessary for understanding urinary incontinence.
- Bladder: The organ that collects and stores urine from the kidneys before disposal by urination.
- Pelvic floor muscles: A group of muscles located in the pelvic area that keep the pelvic organs in place and aid continence.
- Prostate: The gland which surrounds the urethra at the base of the bladder. It releases a fluid component of semen.
- Urethra: The tube which allows for the drainage of urine from the body.
- Urinary sphincter: Two muscles located in the pelvic floor that control the drainage of urine from the bladder.
Risk Factors & Causes of Male Incontinence
Urinary incontinence has a multitude of risk factors and causes that will impact each individual differently.
To design a successful treatment plan, your specialist will need to consider your current condition and medical history.
The muscles in the bladder and urethra weaken with age. More than 50% of individuals suffering from incontinence are aged 50 years and above1.
Due to the proximity of the prostate to the bladder, removing the prostate through surgery may damage the nerves that help control bladder function.
Carrying extra weight around the abdomen increases the pressure on the bladder and pelvic floor muscles. This may lead to pelvic floor weakness over time.
Radiotherapy helps control cancers but also affects healthy tissue. Therefore, radiotherapy can result in damage to the pelvic organs and surrounding tissues, adversely affecting continence.
Stress and urge urinary incontinence may develop after pelvic trauma, especially after pelvic bone fractures, which can damage pelvic muscles and nerves2.
A history of straining may weaken your pelvic floor muscles. Also, a full bowel can press against your bladder or block the flow of urine, causing your bladder to overflow.
Neurological and musculoskeletal conditions such as stroke, dementia, Parkinson's disease, and multiple sclerosis can all adversely affect continence.
Classifications of Male Incontinence
The most prevalent form of urinary incontinence in males is stress urinary incontinence (SUI), however, a small proportion of the male population may also experience urge incontinence.
SUI is characterised as the involuntary of loss of urine during periods of high abdominal pressure or "stress". Urge incontinence is characterised as the persistent feeling or urge to urinate. It is also commonly referred to as Overactive Bladder (OAB).
Some patients will experience symptoms of both types of incontinence, this is commonly referred to as mixed incontinence.
Stress urinary incontinence (SUI) is the involuntary loss of urine due to added pressure to the abdomen, and in turn to the bladder. It is a common side effect of invasive prostate surgery such as radical prostatectomy.
Leakage typically occurs during normal physical movement such as coughing, sneezing, laughing or exercising. This can have a serious impact on a patient’s lifestyle, confidence, and general well-being.
SUI can be caused by surgical interventions that target the prostate or the urinary tract, such as a radical prostatectomy to treat prostate cancer. Damage to the urinary sphincter, nerves, and blood vessels from surgery can all contribute to a patient’s loss of continence.
Classifications of Male SUI
There are three classifications of male stress urinary incontinence:
Type 1 - Mild
Slight loss of urine during strenuous physical activity, no loss when lying down.
Type 2 - Moderate
Moderate loss of urine during gentle physical activity or when changing position, no loss when lying down.
Type 3 - Severe
Severe loss of urine even without physical exertion and when lying down, through to total urinary incontinence.
Did you know?
The majority of patients will regain continence 8-12 months after surgery, however, approximately 15% will remain incontinent and require further treatment3.
Over Active Bladder (OAB) is used to describe a collection of symptoms. OAB is a chronic condition of the bladder that causes a sudden and intense urge to urinate (urinary urgency). Urinary urgency is caused by nerve damage, which results in bladder muscle contractions that happen suddenly and frequently at any time, regardless of the amount of urine in the bladder (urinary frequency). This urge to urinate may cause leakage (urge incontinence).
OAB can also result in the need to urinate multiple times throughout the night. This is referred to as nocturia.
OAB is generally caused by bladder muscles that are overly sensitive or overactive. This overactivity is caused by damage to the nervous system or to the nerves and muscles associated with the bladder.
The cause of the nerve damage is often unidentified. OAB symptoms of urinary urgency, urinary frequency or urge incontinence may be present in people with interstitial cystitis – also known as painful bladder syndrome - an enlarged prostate, or post-radical prostatectomy.