In diagnosing male urinary incontinence it is very important to find the cause of the problem. to find the cause of the problem.
To reverse completely the problem it is necessary to attack its cause. Cith a good clinical history and questionnaires we can reach an accurate diagnosis.
In a first clinical consultation, the physician will ask the person when urine leaks to see if the incontinence is predominantly stress incontinence (stress urinary incontinence) or incontinence due to having to rush to the toilet (urge urinary incontinence). In many patients there is a mixed picture of urgency and stress. In this case it is necessary to try to understand which is the major component and which dominates the picture.
On some occasions, we find overflow incontinence in men from 60-70 years of age in whom there are obstructive problems (prostate hyperplasia, urethral stricture). In this situation it is possible to diagnose them partly by the clinical picture (which is usually more similar to stress incontinence) but especially by the presence of chronic retention of urine.
It is important to collect data using standardized measures, which will help us to better understand what is happening to each man and to assess the severity of the problem. To do this, we have questionnaires and a diary that is given to the patient to indicate the situations in which they leak urine and the amount they leak. This will serve to see the repercussions of these leaks.
In order to evaluate the intensity of urinary incontinence, more or less exact quantitative measures are used, such as the number of times urinary incontinence forces us to change every day or the number of pads or absorbent pads we use. On the other hand, if we want a more precise estimate of the losses, we can determine it by means of the PAD test. This involves using an absorbent pad or pads for a day and weighing them to determine the grams of urine (1 gram is 1 milliliter) lost and, therefore, the intensity of the loss. However, the estimation of the intensity of urine incontinence is usually based on the alteration in the patient's quality of life.
Following this conversation, there are generally two levels of diagnosis:
Initially, tests will be performed to find the origin of the incontinence and to know its severity in order to objectify the magnitude of the leakage. To find the origin, diagnostic tests such as renovesicoprostatic ultrasound, blood tests with PSA and renal function and urinary cytology are used. On the other hand, to determine its severity, diaper test or PAD test is performed.
Secondly, depending on the results of the first battery of tests, other explorations can be performed to try to understand in depth the origin of the condition. These tests are urethrocystoscopy, urodynamics and pelvic MRI.
Normally, all these tests are performed to rule out another condition, but with a good medical history and questionnaires we can reach an accurate diagnosis.
Yes, it is not as common as in women, but it can also affect us. Especially in men with prostate problems or prostate surgery incontinence is more or less frequent.
Yes, strengthening the pelvic floor is very effective in treating urinary incontinence, regardless of the cause.
Some substances such as caffeine, alcohol, spicy foods or carbonated beverages, among others, can worsen urinary incontinence, but we must always look for other causes.
Yes, there are protective measures to limit the extent of incontinence so that you can live as normal a life as possible, but our advice is always to get to the diagnosis in order to solve it.
Diagnostic and therapeutic approach to nocturia in primary care.
Artificial urinary sphincter implant for severe cases of stress urinary incontinence.