What is Male Urinary Incontinence?
People suffering from male urinary incontinence tend to panic without knowing that bladder control problems can be treated. All they have to do is to discover the roots causes and eliminate them.
Urinary Incontinence (UI) is the accidental and uncontrolled leakage of urine. Many men suffer from this, and the risk of encountering this kind of problem increases with age. There are three types of UI, and the doctor will set the treatment schema according to each of them:
- Stress incontinence – urine leaking when performing specific actions like coughing, sneezing, or lifting;
- Urge incontinence – an overwhelming urge to urinate that cannot be halted, followed by urine leaking;
- Urinary overflow incontinence – frequent urinating and in small amounts;
What causes Urinary Incontinence in men?
The main causes of the UI are nerve problems (determined by diabetes, Parkinson’s disease, strokes) or prostate problems. The prostate is a male gland that surrounds the urethra. And whenever its size increases, it pressures on the bladder. The prostate increases with age, and the condition is called benign prostatic hyperplasia. As the prostate’s size grows, it might squeeze the urethra and influence the flow of the urinary stream.
How to Treat Urinary Incontinence?
The best cure for urinary incontinence is an equilibrated lifestyle combined with the correct medications. There is no general cure; every treatment is personalized according to the severity of the issue. Many men do not even need prescriptions. They get to control their bladder by strengthening the muscles holding the urine in the bladder. Others find their last hope in urinary incontinence surgery.
Equilibrated diet – patients should limit fluids for certain times of the day and regularly go to the bathroom to empty their bladder. They may continue this with Kegel exercises after a while.
Pills – some of them block abnormal nerve signals that could determine the bladder’s contraction in the wrong moment. Others are recommended for urinary incontinence because they slow the urine production process. Some drugs shrink the prostate in order to decrease the pressure it puts on the bladder.
Surgery – there are three techniques used in urinary incontinence surgery: replacing the bladder’s sphincter with an artificial one. This kind of intervention requires general or spinal anesthesia. It consists of placing a cuff around the urethra, a balloon reservoir in the abdomen, and a scrotum pump.
Another technique is the male sling when the surgeon wraps a strip of material around the urethra to support it.
The third surgery method is the urinary diversion used when the entire bladder must be removed.
The most important thing is that the last years have brought many alternatives and treatments for male urinary incontinence stress. If anyone suspects suffering from such a condition, the best thing to do is visit the doctor and ask for advice.
Treatment Options
Pelvic Floor Muscle Exercises (Kegel)
Kegel exercises or exercises for the pelvic floor muscles can help overactive bladder issues and incontinence in general.
A pelvic floor is a group of muscles surrounding the pelvic structures, the vagina, the uterus, and the rectum. And these are the muscles for controlling our bladders.
In many cases, overactive bladder patients have poor control of these weak muscles. In some cases, they’re actually sore. And one of the goals of doing the Kegel exercises is to improve these muscles’ strength and control. And then, you use these muscles to help control the bladder.
The best way to do the exercises is when you are sitting or lying down. You should concentrate on contracting the anus, and you squeeze it tight as the one is trying to prevent the passage of gas or a bowel movement. You hold it tight for anywhere from 5 to 10 seconds and then relax the muscle for an equal amount of time. Try to do ten repetitions 3 or 4 times a day.
Periurethral Bulking Agents
It is 5-10 minutes in-office procedure where we inject a little filler called Macroplastique® or Coaptite®. We numb the patient up here in the office and put the camera right inside the bladder. Then we back it out into the urethra and inject a little filler material right underneath the urethra’s lining to plump it up.
Bulking agents help the urethra close so that when you cough, sneeze, laugh, move, you don’t experience leakage.
Usually, it can take up to three injections to see the maximal benefit.
AdVance™ Male Sling
The AdVance™ male sling has been a revolution in treating patients with more mild-to-moderate incontinence.
The sling is polypropylene mesh material, which restores the proximal urethra’s support, where the prostate used to be.
It allows patients with leakage to remain dry when they cough, sneeze, lift, run, or exercise. And the great part about it is that it works instantaneously. Once the sling is in, you should be dry, or 95% improved the next day.
The sling itself is composed of a polypropylene mesh material, which has been around for many years. It is inert, non-cancer causing, and totally safe.
Most men have little to no pain after their procedure. They can get about their daily activities and return to work within one week.
The way the advanced sling works is by supporting the proximal urethra. Once the prostate has been removed, the internal sphincter has been eliminated. You’re dependent upon your external sphincter. In some patients, this can’t compensate well enough.
In this case, the sling works by going under the urethra, lifting it, and supporting it. So that during periods of stress such as coughing or sneezing, the urethra is coapted or closed.
This sling works very well for patients with what we call mild or moderate incontinence.
The way the surgery is performed is that you’ll come into the hospital on the day of the surgery. We do the surgery usually in an hour or less under general anesthesia.
The great thing about AdVance™ is that, once it sits there, your body will grow into it and incorporate it to keep it in place.
The way we place this is by three small incisions. Two incisions are in the crease of the groin, and one incision in what is called the perineum, which is the area underneath the testicles.
The nice part about the male sling is that it works immediately. Once the male sling is placed, you should be dry from that day forward.
Artificial Urinary Sphincter
The artificial urinary sphincter is a remarkable device, which was developed more than 40 years ago. This device can essentially restore urinary control to patients even with the most severe degree of incontinence.
It essentially replaces your sphincter. This device takes a patient who may have had a complete loss of sphincter function and gives them more than 95% control over their bladder.
Once it is implanted through two small incisions, you have three components. There is a pressure balloon, which pushes fluid through tubing into a pump. The liquid then goes into a cuff, which is tailor-sized to your urethra. When the balloon is moving the fluid through into the cuff, balloons inside the cuff will fill and close your urethra, giving you complete urinary control in most cases, or at least 95% improvement.
When it’s time to urinate, you’ll get the normal sensation. You’ll reach down into the scrotum, give this pump one or two squeezes. When you squeeze the pump, the fluid is drawn out of the cuff and is pushed back into the balloon. When the liquid is out of the cuff, the sphincter opens, and you urinate normally.
After 2 minutes, the balloon will push fluid back through the pump and into the cuff, closing the sphincter again and giving you back your control. So essentially, you only squeeze the pump when you want to urinate.
It’s a semi-automatic device, which will basically restore your quality of life and get you back to doing everything you want to do.