Male urinary incontinence is a common condition that affects millions of men worldwide. However, despite its prevalence, the stigma that surrounds the topic prevents men from finding treatment and even talking about their condition openly. It also results in serious life consequences, such as social isolation, missed income, and mental health issues.
With so many men managing in silence, it’s time to start having transparent conversations about male urinary incontinence! By destigmatizing this condition, we can empower men to seek out the support and resources required to manage symptoms, and ultimately, regain their quality of life.
In this article, we’ll explore the causes of male incontinence, its impact on individuals, treatments for incontinence, and ways to finally get rid of the stigma. Let’s end the silence and make male incontinence normal!
IN THIS ARTICLE:
What Stigmas Surround Male Incontinence?
Why Don’t Men Talk About Incontinence?
What Effect Does Incontinence Have on Men?
What Is the Main Cause of Incontinence in Men?
How Do You Know If You Have Male Incontinence?
Can Male Incontinence Be Corrected?
Coping Strategies for Men With Incontinence
What Stigmas Surround Male Incontinence?
It’s estimated that 25 million Americans are affected by incontinence. Out of those 25 million, 3% to 11% of men experience urinary incontinence (UI). And while so many individuals manage the condition at some point in their lives, there are still stigmas that surround every type of incontinence, including male incontinence.
Male UI is surrounded by the stigma that bladder control conditions are:
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- Shameful
- Embarrassing
- Emasculating
- “Gross”
This could be because as a society, we too often deem natural bodily functions and conditions as embarrassing or shameful. Think about the reactions you’ve seen when someone talks about or does pick their nose or pass gas in front of others. These are things we all probably do in the comfort of our own homes, but we consider them to be gross or embarrassing when we’re engaging with society. The same reactions often occur when we discuss or experience toileting issues, like urinary accidents or leakage, when in fact, the opposite is true.
These stigmas may grow out of issues that arise after a man develops UI symptoms and feels judged or stigmatized. Issues a man could face include:
- Loss of bodily control.
- Social interruption.
- Judgment of impotency.
- Anxiety or depression.
- “Problematic” bodily functions.
- Making frequent trips to the bathroom.
- Drawing attention to the body.
Emptying our bladders is a normal, recurrent part of life, and UI is very commonly a part of that. And it doesn’t matter if you’re a man, woman, teenager, or senior- UI can develop in any person of any age for many different reasons.
Why Don’t Men Talk About Incontinence?
All too commonly, men do not discuss UI symptoms with their loved ones or their healthcare providers. In fact, a study by the National Association for Continence (NAFC) reported that 27% of men who experience UI don’t talk about it with their healthcare providers, despite needing help managing symptoms. From the same study, it was concluded that only 1 in 3 men seek out treatment for their UI. Some men may not be willing to discuss UI because they don’t want to be labeled as emasculate, weak, impotent, or problematic, but not discussing UI can have negative affects on physical and mental health.
What Effect Does Incontinence Have on Men?
As you may know, UI can make life difficult- both physically and emotionally- and this is especially true for men. Many men report developing mental health issues while managing UI. One study showed that 90% of men with UI had feelings of isolation, shame, or depression. It’s also been proven that UI conditions like overactive bladder (OAB) and stress incontinence can cause anxiety and stress.
It’s critical that we address the stigmas that society has formed around UI. If we don’t, men will continue to manage their conditions with feelings of shame, anxiety, depression, and fear.
What Is the Main Cause of Incontinence in Men?
There are a variety of different reasons that men may be experiencing symptoms of UI. It’s important to be aware that there will be different side effects due to the cause of the incontinence and the specific type of incontinence that is affecting the urinary system. While often related to prostate problems, urinary incontinence in men has a variety of causes and can also be brought on by medical conditions such as diabetes, Parkinson’s disease, multiple sclerosis, and by pelvic surgical procedures including radical prostatectomy. Other causes include:
- Prostate concerns. When a male has an enlarged prostate, sometimes diagnosed as benign prostatic hyperplasia (BPH), the flow of urine is diminished causing a weak, slow urinary stream along with frequent urination. Incomplete emptying of the bladder may occur and lead to overflow or urge incontinence. If men have prostate surgery to have their prostates removed secondary to prostate cancer, this removes a supporting structure to the bladder and urethra, which can lead to stress urinary incontinence.
- Aging. As we age, our muscles, including pelvic floor muscles, may become weak and atrophy without a regular strength and resistance exercise routine. This can result in diminished ability for the urinary sphincter to efficiently adapt to changes in pressure, including bladder filling, leading to leakage.
- Constipation. Chronic constipation can lead to hard impacted stool in the rectum, which can press on the bladder. In addition, the excessive stress and strain to defecate may cause the pelvic muscles to become less efficient at doing their job with continence control.
- Waist circumference. Increased abdominal girth and waist circumference leads to increased abdominal pressure pushing on the bladder and pelvic floor muscles, which can lead to stress incontinence in men. Increased physical activity can help to combat weight gain and comorbidities such as obesity.
- Diet. Certain foods and beverages can cause irritation to the lining of the bladder, which can in turn lead to symptoms of urge incontinence. Citrus foods, spicy foods, caffeine, alcohol, and dehydration can all lead to bladder lining irritation contributing to urge incontinence.
- Neurological conditions. When the nerves to the bladder become compromised, this can also lead to urinary incontinence in men. Neurological conditions that may cause incontinence include diabetes, Parkinson’s disease, multiple sclerosis, spinal cord injuries (SCIs), dementia / Alzheimer’s disease, herniated discs, and strokes.
- Smoking. Smokers can sometimes develop a chronic cough that leads to an indirect cause of urine leakage, mainly because of the frequency involved which can lead to uncontrolled urination.
How Do You Know If You Have Male Incontinence?
There are 2 primary types of UI that are seen in males. It is important to note that a urologist will be able to properly diagnose the type of incontinence you are experiencing, so your treatment plan can be specialized to your symptoms.
1. Stress incontinence.
Stress urinary incontinence is the experience of involuntary loss of urine during physical and exertional activities like coughing, laughing, sneezing, lifting, or jumping. The pressure from these activities overcomes the muscles holding the bladder and urethra shut.
This type of incontinence is rarer in men than women. However, it can still occur in men. Men typically experience stress incontinence after prostatectomy (removal of the prostate secondary to prostate cancer) or those with chronic cough secondary to long-term smoking.
2. Urge incontinence.
Urge incontinence, which is the more common type of UI in men, is the experience of involuntary loss of urine following a sudden and strong urge to urinate. This can happen when pelvic nerve damage occurs from pelvic or abdominal surgeries. It can also occur after spinal cord injuries (including herniated discs), and it is often seen in neurologic diseases such as Parkinson’s disease, multiple sclerosis (MS), and comorbidities, such as diabetes, that can damage nerves that supply the bladder. Bladder irritants such as citrus foods, spicy foods, caffeine, and dehydration can contribute to urge incontinence, as well.
Other types of incontinence include overflow incontinence, functional incontinence, and mixed incontinence. Mixed incontinence occurs when an individual has more than one type of UI.
Signs of male UI don’t differ too much from the symptoms any other person with UI might have. These can include:
- Unintentional loss of urine when sneezing, coughing, exercising, or lifting heavy objects.
- Dribbling urine after emptying your bladder.
- Needing to use the restroom frequently and urgently (more than 8 times in 24 hours and throughout the night).
Can Male Incontinence Be Corrected?
While UI treatment varies from person to person, most of the time, UI in men can be treated. Try the following lifestyle changes or find a healthcare professional to start the process of UI reversal.
- Pelvic floor retraining. This is a great way to improve urinary incontinence in men. It is highly recommended that the pelvic floor retraining be under the guidance of a pelvic floor physical therapist or an occupational therapist. Pelvic floor PTs are able to determine if you have high-tone pelvic floor muscles or muscle dysfunctions that are leading to your incontinence. They will be able to assess and evaluate your pelvic floor muscles, pelvis, abdominals, and lower back to ensure proper functioning.
- Eating for your bladder. Avoiding foods and drinks that irritate your bladder, such as citrus, spicy foods, caffeine, excessive alcohol, and additional sugar can also help improve UI. Avoiding constipation and ensuring hydration with adequate water intake is beneficial, as well.
- Exercising regularly. Regular exercise, 30 minutes a day, including stretching, can significantly improve pelvic floor muscle and bladder strength. Pelvic floor exercises, such as Kegel exercises, can also be worked into your exercise routine to help strengthen the pelvic floor. And, despite what the stigma says, pelvic floor exercises aren’t just for women- men can do them, too!
- Urinating when needed. Voiding (emptying your bladder) every 2-3 hours is also helpful to not allow your bladder to fill too full, causing urgency and potentially incontinence.
- Bladder training. Bladder training can also be a helpful process in treating incontinence. It is important to discuss your incontinence with your healthcare provider to allow for adequate treatment options for your unique symptoms and needs.
- Using male incontinence products. Incontinence products, such as male bladder control pads, adult diapers, and male protective underwear, are great options to control leaks in a discreet manner. They can be worn at work, at home, while exercising, and while enjoying other activities throughout your day. See if you qualify to get free male incontinence products with Aeroflow Urology.
Coping Strategies for Men With Incontinence
- Seek support from loved ones. Speak to your loved ones about what you’re going through, even if it feels embarrassing at first. Find someone who is non-judgmental and make sure it’s someone you’re comfortable around. Having someone in your corner can help lessen feelings of shame, depression, and embarrassment.
- Join a support group. Knowing that you aren’t alone in managing UI can help normalize your symptoms. You can also get care and treatment tips and resources from others who have gone through the same process you are.
- Adopt a positive mindset. Try to remember that UI is very common in males and that you aren’t alone. Remember that a wide range of treatments are available to men with UI, some of which can be done at home.
If you are managing UI, you can use the following coping strategies while finding treatment.
- Maintain an active lifestyle. Just because you experience urinary leaks doesn’t mean you can’t enjoy everything you did prior to UI. Use resources like incontinence products to make you feel confident and protected while exercising, visiting with friends, or engaging in your other normal activities.
- Encourage Openness & Regular Dialogue. The first step to destigmatizing UI is to talk about it transparently and frequently. If you’re close to someone who has UI, let them know you’re there for support when they need it. If you hear someone else talking about incontinence, be open to educating yourself about how it’s affecting their life without shaming them.
- Educate & Be Aware. Educate yourself on the different types of urinary incontinence and fecal incontinence and be aware that anyone you know could be managing the condition.
- Start Conversations. If you are a person experiencing UI, be brave! Start conversations around your symptoms with your healthcare provider so they can give you the proper help and treatment you need.
- Support Loved Ones. If someone in your life has UI, make sure they know you’re there to support them. Let them know that UI is very common and that it’s nothing to be embarrassed about.
Ending Stigma Around Male Incontinence
It’s imperative that we end the stigma around male incontinence. Let’s take the following steps to break the silence and get treatment for those who need it.
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About the Author
Marlee Septak is the Senior Content Specialist at Aeroflow Urology. She brings a deep understanding of incontinence and health conditions associated with it to her writing. She graduated from Columbia College Chicago and holds a Bachelor's degree in Journalism. Marlee has contributed to various magazines and blogs, including Borgen Magazine, Echo Magazine, Chicago Ideas Week, Assuaged, and Peaceful Dumpling. In her spare time, she enjoys traveling, trying new restaurants, and just sitting down with a good book.
Aleece Fosnight
Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF, HAES is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.
Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.
Dr. Susie Gronski, PT, DPT
References
Jenkins, S. (2019, November 5). Overcoming The Stigma Of Incontinence. National Association for Continence. https://nafc.org/bhealth-blog/overcoming-the-stigma-of-incontinence/
Shamliyan, T. A., Wyman, J. F., Ping, R., Wilt, T. J., & Kane, R. L. (2009). Male Urinary Incontinence: Prevalence, Risk Factors, and Preventive Interventions. Reviews in Urology, 11(3), 145–165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777062/
Nitti, V. W. (2001). The prevalence of urinary incontinence. Reviews in Urology, 3 Suppl 1(Suppl 1), S2-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476070/
Disclaimer
Information provided on the Aeroflow Urology blog is not intended as a substitute to medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.
