Having trouble holding in urine (incontinence) can feel very hard. Your daily life can be heavily affected if you opt out of activities for fear of not making it to a toilet, smelling like urine or leaking through your clothes.
While in most women there are natural causes behind incontinence, male incontinence is more often a sign of physical problems. Therefore, men who are affected should seek medical help. There may be signs of prostate problems, diabetes, urinary tract infection or bladder stones. But incontinence can also be caused by obesity, smoking (smoker’s cough), diuretics and other medications. It’s important to remember that the nerves that control the bladder function less effectively as you get older.
Different types of incontinence:
Urge incontinence (overactive bladder) means that you suddenly and unexpectedly have to pee and quickly find a toilet. The bladder may sometimes drain before you get there. You need to urinate more often than normal (more than 4–8 times per day) and also several times at night. This type is most common and may be caused by an enlarged prostate.
Stress incontinence means that you leak urine when you laugh, cough, sneeze, exercise, jump, lift something heavy or exert yourself in some other way. It is common after prostate surgery (occurs in about 10% of cases).
Mixed incontinence is a combination of urge and stress incontinence and affects about 10–30% of all men.
After-dribble occurs when urine remains in the upper part of the urethra, and dribbles out later. It may be due to an enlarged prostate or weakened pelvic floor muscles.
Neurological bladder disorder
Neurological disturbance means you have a neurological disease, spinal cord injury or some other disease that affects the communication between the brain and the bladder. It makes you suddenly leak or pee yourself. You may also have difficulty emptying your bladder completely or partially.
Overflow incontinence means that the urine flows periodically or all the time. This can be caused for example by a weakened urine bladder.
Training that helps
There are two kinds of exercise that can help you: exercise of the pelvic floor muscles, and retention exercises. Pelvic floor training strengthens the support around the bladder. Squeeze and tighten the muscles around the rectum and forward around the urethra – the same muscles you use to stop the stream when urinating. Hold for a few seconds and relax for an equal amount of time, then repeat several times over a few minutes. As you become comfortable, you can extend the tension and repeat several times. Perform exercises once a day for 2–6 months. Up to 70% of people with mild stress urinary incontinence get better or cured by training. It’s important to continue every day even after you get better. Also, you’re never too old to start.
The training can also help with after-dribble problems. There is also a simple technique for draining the most amount of urine. Place two fingers a few centimetres behind the scrotum, push and pull your fingers along the urethra, up against the penis base and out along the penis.
With urge incontinence, it’s important that you hold your pee in for as long as you can before urinating, so as to train the bladder, thus reducing the number of urinations per day.
There are medicines, other aids and electrical stimulation that your doctor or urologist can tell you about. They can advise and prescribe specially designed absorbent incontinence products that also help to prevent urine odour.
One thing it’s important to know is that incontinence does not affect potency, unless you worry about it and cause problems that way.