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urinary incontinence in men

The embarrassing and inconvenient problem of urinary incontinence in men, which affects 3.4 million Americans, is not a normal part of aging. Healthcare practitioners need to be prepared to talk with male patients about this treatable condition.

Types of Incontinence in Men

Urinary incontinence in men can be either sudden or chronic. Here are the four main types:

  1. Stress Incontinence: activities like bending, sneezing, lifting, or coughing put pressure on the bladder and trigger leaking
  2. Urge Incontinence: bladder contractions trigger an overwhelming sense of the need to urinate, making it hard to get to the restroom on time
  3. Overflow Incontinence: unexpected leaking that occurs even though bladder has just been emptied and there is no urge to urinate
  4. Mixed Incontinence: a combination of two or more of the above, usually stress and urge incontinence

Causes of Incontinence in Men

Frequently, male incontinence is caused by medical conditions. Ruling out treatable disorders like urinary infections, constipation, and obstructions is an important first step in diagnosis. Other common causes are:

  • Epididymitis
  • Enlarged prostate
  • Prostate removal (scar tissue)
  • Radiation treatments
  • Medications
  • Diabetes
  • Overactive bladder
  • Obstruction like a tumor in the urinary tract or urinary stones in the bladder
  • Neurological disorders like a stroke, brain tumor, spinal injury, or Parkinson's

Risk Factors for Incontinence in Men

Older men have a greater risk for incontinence because changes with age reduce how much the bladder can hold, as well as the strength of the muscles in the bladder and urethra. Other risk factors include:

  • Extra weight: especially for men who tend to carry their weight in their abdomen, extra weight can increase the pressure on the bladder and cause stress incontinence
  • Smoking: using tobacco can increase urinary incontinence in men
  • Prostate Treatment: radiation treatment or prostate surgery can cause injury to the bladder or urethra - structural abnormalities in the urinary tract from prostate treatment is a leading risk factor
  • Family History: urge incontinence tends to run in families

9 Management Strategies for Incontinence in Men

One common strategy for management of incontinence in men is to carefully regulate fluid intake during the day and not have liquids before bed. While that can help, restricting liquids can also cause dehydration and other complications like bladder infections. One helpful technique to start with is for the individual to keep a chart of liquids and urination, and to use the chart to track changes that take place using any of the following strategies:

  1. Change Liquids: rather than eliminating or reducing liquids, this strategy seeks to eliminate liquids that irritate the bladder or act as a diuretic. Generally, this list includes drinks with caffeine, carbonated sodas, and alcohol.
  2. Adjusting Diet: some incontinence in men can be managed by dietary changes. Since this only works for some people, it helps to have an individual use a food diary to record what they eat, along with symptoms they experience. Foods that tend to trigger problems are spicy or acidic foods, chocolate, and artificial sweeteners.
  3. Reduce Stress: sometimes incontinence in men is triggered by stress, and breathing exercises, biofeedback, or meditation can help an individual relax, ease their muscles, and get better control of their symptoms.
  4. Behavioral Techniques: individuals with urge incontinence may benefit from bladder training, which starts by having the person go to the bathroom every half hour at first - then gradually expands the time between bathroom breaks until the spacing is a more normal 3 to 4 hours.
  5. Kegel Exercises: regularly tensing the muscles of the pelvic floor can help the bladder hold urine.
  6. Use Protection: using pads or adult disposable undergarments can be an important way to manage the problem while trying other strategies to eliminate it.
  7. Medications: for urge incontinence, some muscle relaxants, nerve blocking drugs, or medications that shrink the prostate can help.
  8. Devices: external catheters or intermittent catheterization can help at night or for overflow incontinence.
  9. Surgery: for stress incontinence in men that can't be managed by other techniques, surgical options include a male sling or artificial sphincter.

Urinary incontinence in men is a difficult issue for some men to discuss. Health care personnel can be alert for the presence of risk factors in patients, so that they can initiate discussion of the issue and offer possible management strategies to alleviate discomfort and eliminate (or at least reduce) instances of the problem.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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