Male Incontinence

Image: male urinary tractAs with women, many men don't report their incontinence to their physician. However, estimates are that approximately 5 million men in America suffer from this highly treatable condition. Common causes are prostate problems, injury, urinary tract infection, neurological disease, toxins such as alcohol, and simply aging.

Three common types of male urinary incontinence:

Urge Incontinence
Urge incontinence, which is a sudden, uncontrollable urge to void, is caused by a sudden abnormal contraction of the bladder that is stronger than the urinary tract muscles can control. The patient generally leaks urine before he can get to a bathroom. The most common cause of this abnormal contraction is an enlarged, obstructed prostate gland — usually a benign condition. To overcome the obstruction caused by this enlarged gland, the bladder thickens and can develop abnormally strong involuntary contractions. Other causes of urge incontinence include neurological conditions such as stroke, spinal cord injury or multiple sclerosis. 

Intrinsic Sphincteric Deficiency (ISD) 
ISD is a weakness of the bladder neck and sphincter muscles usually caused by a surgical procedure, such as a total prostatectomy, radiation or cryotherapy for prostate cancer, spinal cord or pelvic injury. Depending upon the severity of the weakness the patient may have small amounts of leakage with coughing or straining, which classifies as stress urinary incontinence. More severe forms may result in total incontinence and a constant leakage of urine 24 hours a day.

Overflow Incontinence
Overflow incontinence is caused by a bladder that becomes completely dysfunctional. This usually is a chronic process but starts out with an obstruction at the prostate or urethral level. The bladder initially squeezes harder trying to empty but as it gradually weakens, more and more residual urine accumulates. As the bladder volume slowly increases, the bladder wall gets thinner and the contractions get less and less forceful. Eventually, the bladder function is completely destroyed and the volume of the bladder gets so large, that as the patient is active, small amounts of urine seep out of the urethra throughout the day. 

Other causes of a dysfunctional bladder could be neurological injuries due to diabetes or B-12 deficiencies, spinal cord injury, stroke, dementia or the bladder simply wearing out with age.