Urinary Incontinence: The Common Health Problem in Men That No One Talks About
Guys, urinary incontinence isn’t just for women. Here’s everything men need to know about bladder leakage but were too embarrassed to ask.
Men suffer from bladder leakage too
Bladder leakage—urinary incontinence (UI)—is an unfortunate reality for an estimated one in ten people. Most experts believe the actual number is even higher since many sufferers won't talk about it or seek medical help.
Despite the fact that many men experience incontinence issues, it's still seen as a "women's issue." That only adds embarrassment to an already difficult situation, says Jennifer Berman, MD, a urologist, sexual health expert, and co-host of the TV show, The Doctors. And despite UI's reputation as an "old person's" disease, it can affect men of any age. One in four men who've experienced bladder leakage say they are too embarrassed to even talk about it with immediate family members, according to a survey done by Continex. This means only one in 12 people seek help for their symptoms, according to the National Association for Continence.
Not all UI problems are the same
You'll need to figure out what's causing your leakage before trying to treat it, Dr. Berman says. Bladder leakage can range from the mildly annoying to majorly disrupting your life, but you can't figure out the cause if you don't talk to your doctor about it, she adds. The first thing to know is that there are three main types of incontinence...
This is the jumping-jack, swinging-a-golf-club, lifting-a-kid, sneeze-induced variety of bladder leakage. It comes on suddenly in response to some physical stimuli and stems from pelvic floor weakness or a weak urinary sphincter (or both), Dr. Berman says. Because men have a longer urethra than women, they are more prone to sphincter-related problems, she adds. This type is usually a "spurt" of urine and not a complete emptying of the bladder.
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Do you feel like you have to go all the time? Even if you just went to the bathroom? With this type of urinary incontinence, the bladder has involuntary contractions or spasms, causing the urethra to open at random times to let urine leak out, Dr. Berman says. It can range from a little dribble that you barely notice in your boxer shorts to a full-on flood.
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This is the opposite of urge incontinence: Instead of feeling like you need to go all the time, you never feel the need to pee. Imagine your bladder like a water balloon connected to an open tap. It just keeps filling and getting bigger until it eventually overflows (your urethra being the opening), Dr. Berman explains. The urine comes out randomly—sometimes leaking constantly or sometimes coming out in big gushes, she says.
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What your prostate has to do with your pee
Prostate problems are usually the first thought men have when experiencing urinary incontinence. The prostate can be a cause of UI, though not in the way most men think, according to Dr. Berman. An enlarged prostate gland is more likely to make it more difficult to urinate than it is to cause incontinence; however, prostate surgery nearly always causes incontinence, she explains. "Any method of prostate surgery can cause injury to the bladder nerves and urethral sphincter, which will cause leakage," she says. It's normally just temporary, but men and their doctors need to be aware of this side effect and have a plan for how to deal with it while they heal, she adds.
Get the right meds
Dr. Berman warns that some of the drugs used to treat male incontinence can actually make the problem worse: For instance, if doctors treat a man with bladder spasm medication, but his leakage is due to kidney stones, the patient could end up worse than before. Other medical causes include back surgery and some blood pressure medications, Dr. Berman adds.
Diseases that can cause incontinence
Diabetes is top of the list for conditions linked to bladder leakage; it damages the nerves in the body, including those that lead to the bladder, Dr. Berman explains. Incontinence can also be caused by bladder cancer, constipation, a stroke, a urinary tract infection, kidney or bladder stones, STDs, or a neurological disorder like Parkinson's or multiple sclerosis.
Lifestyle factors that cause incontinence
Add incontinence to the list of health problems triggered by obesity. The extra weight can put pressure on the bladder, causing it to leak, Dr. Berman says. Another factor can be the excruciating-sounding "straddle injuries" people can suffer in car accidents and sports. Any injury to the urethra or groin area, or to the spinal cord, has the potential to cause leakage, she adds.
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Preventing and managing bladder leakage
"Men need to accept that this isn't something that's going to get better on its own," Dr. Berman says. "Because it's not usually painful and is often infrequent, men will try to brush it off." Don't do that. If you are waking up more than once a night to pee, if you're experiencing any leakage during the day, if you're urinating more often than every four hours, or if leakage is cramping your lifestyle in any way—see your doctor right away. You can start with your general practitioner, Dr. Berman says, but it's best to see a urologist who can check you for everything from injuries to cancer (and, yes, your prostate).
Kegels are now a group activity
When it comes to preventing and managing stress incontinence, Kegels are now a boy's best friend, Dr. Berman says. While women have been aware of the pelvic-floor-strengthening exercises forever, men may be new to the "squeeze and lift" method. So enlist your female significant other for help and you can practice your Kegels together. Bonus: Kegels can also help prevent premature ejaculation.
No more coffee and spicy breakfast burritos
Surprisingly, your diet can trigger or worsen your bladder leakage, Dr. Berman says. "Caffeine is the worst offender," she says, "but also avoid carbonated beverages, spicy foods, and anything else that you notice that irritates your bladder."
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Pull out your walking shoes
Living a healthy lifestyle will go a long way in preventing and managing bladder leakage, according to Dr. Berman. Do all the things you know you should be doing—eat a balanced diet, get regular exercise, reduce stress, limit alcohol, and maintain a healthy weight—and your bladder will thank you.
Don't be afraid to use adult you-know-whats
While you're figuring out what's causing your urinary incontinence, you'll need to take measures, and adult diapers have come a long way. The new products on the market are nothing like the diapers of old, Dr. Berman says. They look just like normal briefs: They have a little extra padding up front while laying flat everywhere else. And keep practicing those Kegels.
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