Male Urinary Incontinence

What is male urinary continence?

Male urinary incontinence is defined by the involuntary loss of urine. Although more common in women, many men also experience this problem, affecting their quality of life and emotional well-being. Incontinence can range in severity from small leaks to a continuous loss of bladder control.

There are several possible causes of male urinary incontinence, such as prostate problems, nerve damage, sphincter muscle weakness or urinary tract infections.

Types of urinary incontinence

There are four types of urinary incontinence:

1. Stress urinary incontinence occurs when performing certain activities such as running, laughing, coughing or lifting. These activities increase the pressure inside the abdomen and cause the urinary sphincter to "fail". Stress urinary incontinence usually appears, when mild, only in the evenings. This conditions men's activity, as they tend to be less active when they detect that it causes more leakage. As stress urinary incontinence worsens, it appears throughout the day or related to exertion. Depending on the severity, urinary incontinence will alter to a greater or lesser extent the daily life of each person, and can have a great impact on daily life, even limiting social activities in very advanced cases.
2. Urge urinary incontinence. Urine leakage occurs just after the onset of an urgent and compelling urge to urinate, which we cannot control. Urge incontinence also causes many men to limit their activity because the urge appears in unpredictable and even dangerous situations (driving, climbing a ladder, using dangerous objects, etc.).
3. Mixed urinary incontinence. Mixes elements of the two previous types of urinary leakage.
4. Overflow incontinence. This is not strictly speaking incontinence, although many men refer to it as such. When the urinary bladder is chronically overfull, there are times when the bladder cannot hold any more urine and pressure increases to the point of losing some urine. It can be confused with stress urinary incontinence.

Before defining the treatment to resolve male urinary incontinence, the urologist should:

1. Define the type of incontinence: it guides us about the causes and clinical characteristics of the symptoms (morning-night, predictable-unpredictable, mild-severe).
2. Identify if there is any treatable cause that is causing urinary incontinence or may be worsening it, such as the consumption of any substance or too much water.
3. Perform a study with complementary tests such as ultrasound, urine culture, urethrocystoscopy, urodynamics or blood tests to try to determine the cause of the problem and its intensity. In many cases, the intensity of urinary incontinence also leads us to certain treatments.
4. Explain diagnostic findings to the patient in order to develop a treatment plan. On many occasions it will be necessary for the patient to make important lifestyle modifications or implement pelvic floor rehabilitation strategies, so the patient must be informed and motivated to perform these tasks.