Urinary incontinence can be an embarrassing problem for men and women. You usually hear about urinary incontinence in women. But the same can happen to a man in different circumstances.
In this article, we are going to cover the topic thoroughly. First, we’re giving you a list of common prostate conditions. They are the most common causes of urinary incontinence in men.
We’re giving you a list of symptoms to know if you suffer from prostate enlargement. Then, we’re breaking down incontinence into different types and cover incontinence surgery as a therapeutic option.
After that, you will get a list of incontinence products men can use in these cases and where to find them. Of course, even with the latest technology, you might not be able to hide urinary incontinence from everybody. That’s why we’re also giving you a few useful tips to raise the topic with your loved ones.
This is a thorough guide where you will find answers to your questions about incontinence. So, let’s begin with the first topic in the list.
Common prostate conditions
The prostate gland is a small organ located next to the urinary bladder. It surrounds the urethra, which the urine goes through to be eliminated. So, when something affects the prostate, it can also affect the urinary bladder and the normal urine flow. The same happens when the urinary bladder is infected or inflamed. The prostate can become temporarily inflamed, too.
So, if you’re a man experiencing urinary symptoms, you need to know about prostate health. Here’s a list and a short explanation about the most common prostate conditions:
- Benign prostatic hyperplasia (BPH): It is by far one of the most common prostate conditions. It is basically an enlargement of the prostate without a malignant tumor. The number of cells in the prostate increases (that is what hyperplasia means). As it does, the prostate increases in size and pushes around all of the surrounding organs. The bladder and the urethra are often affected. That’s why patients typically develop urinary symptoms. This condition is likely to affect men after age 40 years. As we grow older, the chance of prostate enlargement increases. Luckily, this is not cancer and won’t necessarily transform into cancer (1).
- Prostatitis: It is the inflammation of the prostate gland, usually associated with a bacterial infection. Unlike BPH, prostatitis is more common in young people. Thus, you will rarely find a case in men after turning 50 years. Prostate infection comes from the urinary bladder or the urethra. Sometimes bacteria are spread in the blood or lymph. In any case, it features urinary symptoms and can be acute or chronic. In some cases, you can be diagnosed with prostatitis without having any symptoms at all. It is called asymptomatic prostatitis, and it is the only type that does not require treatment. The rest is usually relieved with a combination of antibiotics (2).
- Prostate cancer: It is the most common type of cancer in men. Actually, the risk of prostate cancer increases with age, similar to BPH. In some cases, prostate cancer can be slow-growing and not mortal. Thus, some seniors can develop prostate cancer and die from unrelated causes. But other forms of cancers are very aggressive and spread rapidly to other organs. The main symptoms are similar to BPH because the prostate grows and causes compression. In this case, treatment varies according to the aggressiveness of cancer. In some cases, doctors will recommend active surveillance. In other cases, they program surgery and start chemotherapy right away (3).
Symptoms of an enlarged prostate
When the prostate increases in size, patients start to experience a series of urinary symptoms. For example (4):
- Nocturia: It is often one of the first reported symptoms in BPH and prostate cancer patients. Nocturia means waking up several times at night to urinate. This happens because the total volume capacity of the bladder is reduced.
- Increased frequency of urination: Patients need to go to the bathroom more often than usual. In severe cases, they may even feel discouraged to go out of the house to prevent awkward situations.
- Urgency and hesitancy: Urinary urgency has an insistent urge to urinate. In some cases, it can be accompanied by urinary incontinence. Hesitancy is when you have problems maintaining the urine flow. It comes and goes when you’re voiding. The flow is not constant and may sometimes stop and resume.
- Difficulty to start voiding: Patients sometimes need to push very hard to start urinating.
- Weak urinary stream: The urinary stream is slower with a small-caliber. Thus, the volume of urine eliminated each time is reduced.
- Incomplete voiding: Patients feel they have not fully emptied their bladder after voiding. They may confirm this by performing a post-void ultrasound showing a significant volume of urine that is still in the bladder.
- Post void dribble: This is also known as a post-micturition dribble. It happens after voiding when you feel that you’re done. But some remaining urine is left inside of the urethra. This remaining urine is release as you walk back to the office or do something else. It might be enough urine to wet your underwear or even your pants. This is because the muscles that surround the urethra are not contracting correctly. It is not incontinence by itself but may have a similar effect on you.
- Urinary incontinence: Not all cases of prostate enlargement lead to urinary incontinence. This is often a more severe symptom when the disease is advanced. Patients may feel that they suddenly need to go very urgently. In other cases, they have bladder leakage when laughing or making abdominal pressure. Patients may have what we know as an overactive bladder. The bladder starts emptying inappropriately, and the muscles contract on their own.
Types of prostate-related incontinence
Men with a prostate condition may develop three types of incontinence. They are stress incontinence, urge incontinence, and overflow incontinence. However, you may be experiencing some urine leaks without incontinence.
This is because of a post-void dribble, as noted above. It is a symptom of prostate enlargement that is often confused with incontinence.
Do you have a post-void dribble? If you experience leaks right after voiding, it is a possibility. The recommendation would be either waiting some time and cleaning thoroughly after voiding or using a male incontinence pad after voiding.
But what if your urine leak episodes are not due to a post-void dribble? Then, you may need to consider one of these types of urinary incontinence:
- Stress incontinence: You have stress incontinence when the bladder leaks happen right after laughing, sneezing, coughing, or doing exercise. Anything that increases the abdominal pressure triggers stress incontinence. The most common cause is a weakness in your pelvic floor muscles. They are not as flexible as they should be and can’t stand an increase in bladder pressure. Men with overweight, obesity, and chronic constipation are at a higher risk (5).
- Overflow incontinence: The best way to describe this type of incontinence is when you’ve been holding urine for a very long time and can’t hold it anymore. It is an involuntary relaxation of the sphincter when it cannot hold any more bladder pressure. At the same time, the bladder muscles contract and squeeze the bladder contents. Thus, these episodes are not only small leaks. They are usually very noticeable. Men with advanced BPH or prostate cancer are at a higher risk. This type of incontinence is often associated with bladder infection due to urinary retention (6).
- Urge incontinence: This type of incontinence feels like a sudden and unexpected urge to void. If you don’t do it on time, you will experience a urine leak, which is usually not massive. It may not be noticeable at first sight, but it does affect the quality of life. In BPH and prostate cancer patients, the bladder is working double to get past the obstruction. Thus, it becomes overactive and sometimes tightens on its own. When that happens, you feel this sudden urge to urinate (7).
Does incontinence resolve post-surgery?
If you have incontinence due to BPH or prostate cancer, the chances are that you need surgery. As noted above, urinary incontinence is often a late-stage symptom. It only appears when the prostate is very large and obstructing a great deal of urine.
In these cases, it would be urge incontinence due to an overloaded and overactive bladder or overflow incontinence because the bladder cannot hold any more obstructed urine.
It might be required to take out the prostate via surgery for faster symptom relief in both cases.
After surgery, your incontinence symptoms will likely improve. Remember that you will have a urinary catheter placed after surgery. When you’re back home and the catheter is removed, you might experience symptom improvements right away. In other cases, it takes 6, 8, and sometimes 12 months to experience a real difference (8,9).
Remember that incontinence is only one of the symptoms of BPH and prostate cancer. You might experience relief of other symptoms before improving your incontinence. In some cases, patients have other causes of incontinence, such as obesity or neurologic dysfunction. If that is your problem, surgery might do a partial job but not completely cure incontinence. In some cases, patients do not feel any improvement at all, even after surgery (8,9).
Urinary Incontinence Products for Men
If you’re waiting for full recovery after surgery, what can you do in the meantime? A good option is using urinary incontinence products for men. There are different types you can consider depending on your needs. Some of them are disposable products, others are reusable, and you also have external collection devices.
Disposable incontinence pad
- Male drip collectors: They are small devices with a shield that slips around the penis. They are made of waterproof materials and contain a substance that turns urine into a gel. They are designed to catch small leaks such as post-void dripping. It can be useful in moderate cases but not in severe incontinence.
- Disposable liners: This alternative is suitable for light or moderate incontinence. They are absorbent sheaths that you place on your underwear. They come in only one size and can be used along with incontinence underwear or absorbent briefs.
- Male incontinence guard: They are also useful for cases of light or moderate incontinence. They come with an elastic pouch that creates a cup-shaped pad. It is all held in place with adhesive. You can look for male incontinence guards with foam backing if you need some extra capacity.
- Absorbent pad: These are probably the most popular because they are suitable for any type of incontinence. Of course, these disposable pads won’t hold a massive leak. However, you get to choose absorbency level and thickness. You can simply place these absorbent pads inside of your briefs or regular underwear.
- Fitted brief: This alternative is appropriate if you’re experiencing several leaks in your sleep. It is a one-piece garment with a tight fit and elastic legs. Other versions do not have flexible legs but a cloth outer cover instead. These are more suitable than adjustable leg briefs if you have sensitive skin. This product is meant for heavy incontinence or moderate incontinence.
- Protective underwear: It is absorbent underwear that comes on and off pretty easily. It is made of cloth and elastics, and you can use it along with other absorbent products for extra leakage protection. They look like adult diapers.
Reusable products for male incontinence
- Reusable liners: They work similarly to disposable liners described above. However, these are washable and made of cloth.
- Leak-resistant pants and briefs: If you have a severe incontinence case and need to use different products simultaneously, these pants and briefs can be a great solution. They are made of comfortable fabric with a tight fit. You can keep your absorbent products in place with them. If you experience a leak, they are washable and fully reusable.
- Absorbent shorts: These look like boxers and are adjusted to the skin. They have porous materials in the crotch area. If you experience a leak, they are washable and reusable.
External collection devices for male incontinence
- External catheter: It is also known as a condom catheter because, in practice, it looks similar to a condom. They come in different sizes and styles, and you may need to figure out which one is best for you. It is like a catheter that collects your urine. But instead of being inside of the urethra, it is wrapped around the penis. It will be held in place with an adhesive on the internal surface. If you have skin problems with an adhesive strip, there are also models with a strap. They are wrapped around the penis and held in place. It is important to change these products regularly and care for your penis skin.
- Urinals and toilet substitutes: In some cases, standing up and walking to the bathroom is not an option. That’s why plastic urinals are always great aids, especially for those with mobilization problems. It is an appropriate solution for cases of urge incontinence and if you’re stuck in traffic or places with no bathroom.
- Other external urinary collection devices: The market for male incontinence devices has flourished, and you can find many variations for external collection. For example, one of them is held in place with hydrocolloid adhesive on the tip of the penis. The collection bag can be easily concealed if you wear shorts or boxers.
Other devices for male incontinence
- Penile clamps: They are also known as external compression devices. What they do is creating some pressure upon the urethra. Thus, it stops your urine leakage by temporarily closing the urine flow. It does not feel uncomfortable because the surface in contact with the penis is padded with foam. However, these devices can only be used for a few hours and for light incontinence. Otherwise, you can experience skin irritation or penile circulation issues.
- Absorbent covers: These are also known as underpads or bed pads. You can add extra leak protection to your furniture or mattress by using these waterproof products. They are meant to be placed whenever you’re sitting or lying. They can be disposable or washable, depending on the type.
Where Can I Find Men’s Incontinence Products?
A safe bet would be a medical supply store, but you can also find some of these products in a drugstore. The most common are disposable undergarments and disposable incontinence pads for men. Sometimes these are available in supermarkets, too.
However, some of us are not comfortable buying one of these products. So, instead of doing that in a store, you can do it online. Explore medical supply stores and try to find the best incontinence product according to your case. They may also have more variety of products than your local medical supply store.
You can also ask your urologist for recommendations. They will consider the severity of your condition and suggest the most appropriate device for you.
Tips to help you raise the topic
Even if you have every protection device considered by men, sometimes incontinence becomes difficult to handle. You always need social support to get over this type of situation. And for social support, you need to communicate what is happening.
You need to talk about incontinence with some people. Maybe your close friends or some family members. Sometimes your boss.
It is not an easy conversation to have. But here’s a list of useful tips that may be helpful for these cases:
- Treat incontinence as another health problem. Remember that this your body acting out, not your fault.
- Choose the right people to talk about this problem. Close relatives should know about this. If you’re going on a trip with friends, talk to one of them beforehand. They might be very helpful when things go south.
- Be clear on what type of incontinence you have and what type of protection you use. That will make you feel more in control of your own problem. You’re actually doing something about it.
- Dismiss judgmental or unexpected responses. Sometimes people say stupid things when they do not know what to reply.
Incontinence supplies can be found in medical supply stores or online. You have different male incontinence products, including disposable pants and absorbent pads placed in your normal underwear.
Depending on the type of incontinence and its severity, you might need one or another device. Thus, it is essential to detect symptoms of incontinence early and understand the most important types.
If you have a doubt or do not know how to use them, talk to your doctor about it. It might not be easy to bring up the subject, but you might feel better if you speak confidently, talk about your suspicions and what you’re doing about your situation.