Male Urinary Incontinence

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UT Southwestern specialists have extensive experience in treating urinary incontinence in men. Our team members are experts at providing safe, effective treatment for underlying conditions to improve patients’ well-being.

Expert Care for Male Urinary Incontinence

Urinary incontinence is the unexpected leakage of urine caused by a lack of bladder control. It is not a disease; it's a symptom of a problem with a man's urinary tract. Urinary incontinence is more common in women than in men, but in both groups it increases with age.

The urologists at UT Southwestern Medical Center are internationally recognized leaders in the treatment of urological conditions that affect men. Many of the therapies we provide for urinary incontinence are available at only a few medical institutions worldwide. Our physicians were the first in North Texas to offer botulinum toxin (Botox®) injections for neurogenic bladder dysfunction. In addition, our team leads groundbreaking research in incontinence and other urology-related areas.

Types Urinary Incontinence

There are different types of urinary incontinence, each with different symptoms. The five main types are:

  • Stress incontinence: Urine leakage occurs when efforts such as coughing, sneezing, laughing, or exercising put pressure on the bladder.
  • Urge incontinence: Also known as overactive bladder, this type involves a sudden, intense need to urinate, and urine leaks before the person can get to a toilet.
  • Overflow incontinence: When the bladder does not completely empty during urination, it can become too full, leading to frequent urine leakage.
  • Functional incontinence: Problems such as a physical disability, mental impairment, or other barrier can prevent a person from reaching the toilet in time.
  • Mixed incontinence: People can have more than one type of urinary incontinence, called mixed.

Causes of Urinary Incontinence

Urinary incontinence in men is often related to prostate problems or treatments. An enlarged prostate can push against the urethra, the tube through which urine leaves the body, causing problems with urination. Additionally, prostate removal might damage the sphincter, a muscle that controls the flow of urine.

The most common causes of urinary incontinence in men are:

  • Benign prostatic hyperplasia (BPH), a noncancerous, age-related condition in which an overgrowth of prostate tissue obstructs the urethra
  • Prostate cancer treatments, which can disrupt the way the bladder holds urine, reduce bladder capacity, or damage the nerves that help control bladder function

Other causes of urinary incontinence in men include:

  • Bladder cancer
  • Blockage in the urinary tract, such as bladder stones
  • Certain foods or drinks that act as diuretics, increasing urine production, such as caffeine, alcohol, spicy foods, or citrus fruits
  • Certain occupations, such as those that involve heavy lifting or exertion
  • Dementia or other mental health issues that make it difficult to notice the urge to urinate
  • Diuretic medications such as heart or blood pressure medications, muscle relaxants, or certain sedatives
  • Diabetes
  • Injuries to the urinary tract or to the nerves or muscles that control its organs
  • Neurological conditions such as multiple sclerosis, spina bifida, or Parkinson’s disease
  • Trauma to the pelvis
  • Urinary tract infection
  • Weakened pelvic floor muscles

Diagnosing Urinary Incontinence

Our urology specialists have extensive experience in evaluating symptoms to diagnose the specific type of incontinence. We begin with a thorough evaluation that includes a:

  • Review of personal and family medical history
  • Discussion of symptoms
  • Physical exam

To confirm a diagnosis, we might recommend one or more additional tests, such as:

  • Blood tests: Tests of a patient’s blood sample to check for signs of infection, kidney disease, or other problems
  • Ultrasound: Imaging that uses sound waves to produce images inside the pelvic region of the urinary tract and other organs
  • Urodynamic studies: Bladder function tests that measure bladder capacity, bladder pressure, urine flow, and amount of urine remaining in the bladder after urination
  • Urinalysis: Test of a patient’s urine sample to check for blood, signs of infection, or other problems
  • Urine culture: Test of a urine sample that determines the type of bacteria in an infection
  • Cystoscopy: Procedure that inserts a lighted scope into the bladder to examine the urinary tract

Treatment for Urinary Incontinence

Our specialists design treatment plans that are customized to each patient’s individual needs. We typically begin treatment for urinary incontinence with conservative methods such as medication to improve bladder function. These medications include:

  • Anticholinergics such as oxybutynin to relax bladder muscles
  • Mirabegron to increase bladder storage and help empty the bladder more completely
  • Botox® injections into the bladder to relax muscles
  • Alpha blockers to relax bladder and prostate muscles to help empty the bladder

Other nonsurgical treatment methods for urinary incontinence include:

  • Behavioral techniques: Fluid management and bladder training to delay urination (timed voiding) and empty the bladder more completely
  • Lifestyle changes: Reducing fluid consumption, avoiding food and beverages that worsen incontinence, losing weight, and increasing physical activity
  • Pelvic floor therapy: Kegel exercises and other techniques to strengthen pelvic floor muscles
  • Biofeedback therapy: Devices that can be used along with Kegel exercises
  • Condom catheter: External urinary catheter, worn like a condom, that collects urine as it drains out of the bladder
  • Electrical stimulation: Temporary placement of small electrodes inside the rectum or on the skin to send tiny electrical pulses that contract and strengthen pelvic muscles
  • Penile clamp, a device placed around the penis to prevent urine leakage

If surgery is needed, our skilled reconstructive urologists offer procedures such as:

  • Sling surgery: Use of tissue from elsewhere in the body or synthetic material to create a support that helps keep the bladder neck closed
  • Artificial urinary sphincter: An inflatable cuff can be placed around the bladder neck (where the bladder meets the urethra); the cuff is controlled by a pump located in the scrotum (men)