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Male Stress Incontinence

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Dr. Lawrence Jenkins

What is Stress Urinary Incontinence (SUI)

Stress Urinary Incontinence (SUI) occurs when urine unintentionally escapes from the body due to sudden pressure on the bladder and urethra. This pressure can overcome sphincter muscles or cause a brief opening of the sphincter, leading to urine leakage. Mild SUI may result from forceful actions like sneezing, laughing, coughing, or intense workouts, while more severe cases involve leaks during less forceful activities such as standing, walking, or bending over. These urinary “accidents” can range from a few drops to enough to soak through clothing.

Types of Incontinence: There are two primary types of urinary incontinence:

  • Stress Urinary Incontinence (SUI): Involves the release of a small to moderate amount of urine without control, triggered by actions like coughing, sneezing, or laughing.
  • Urge Urinary Incontinence (UUI) or Overactive Bladder (OAB): Characterized by a sudden, uncontrollable urge to pass urine, with leaks varying from moderate to substantial.

Causes of SUI: Common risk factors for SUI include:

  • Nerve injuries to the lower back
  • Pelvic or prostate surgery
  • Smoking (leading to chronic coughing)
  • Chronic coughing
  • Being overweight

Symptoms of SUI: The primary symptom of SUI is urine leakage during actions that exert pressure on the belly. These leaks can range from a few drops to soaking through clothes. Mild SUI may be triggered by activities like workouts, sneezing, laughing, or coughing, while more severe cases may involve leaks during standing, walking, or bending over.

Treatment Options for SUI:

Lifestyle Changes and Products

  • Weight loss, smoking cessation (to reduce coughing), and maintaining good health.
  • Pelvic Floor Muscle Exercises (Kegels): Daily exercises proven to strengthen the pelvic floor, supporting the bladder and other organs.
  • Absorbent Products: Pads or pull-on briefs for quick-fix or long-term use.

Medical Devices for Men:

  • Penile clamp/clip to limit urine flow from the penis.

Drugs

  • No drugs approved in the U.S. for SUI. OAB drugs may be recommended for those with mixed incontinence but do not treat SUI.

Surgical Treatment:

  • Sling: A sling acts as a hammock to lift or support the urethra and sphincter muscles, primarily for men with mild SUI.
  • Artificial Sphincter: This device, with three parts, is surgically placed to control SUI in men with the highest success rate. It involves a fluid-filled cuff around the urethra, a pressure-regulating balloon in the belly, and a pump in the scrotum.

After Treatment: The goal of any incontinence treatment is to enhance the quality of life. Surgical treatments, particularly when combined with lifestyle changes, often prove effective. Regular Kegel exercises help maintain pelvic muscle strength. If SUI problems persist, discussing alternative options with a healthcare provider is recommended.

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