Incontinence is the involuntary loss of urine or the inability to control urine for any reason. During childhood, bladder control usually develops sooner in girls than in boys, and bedwetting is more common in boys, but urinary incontinence is about twice as common in adult women as in adult men. Approximately 17% of American men over the age of 60 will be affected with some type of incontinence.

Male urinary incontinence can be acute, temporary or chronic and result from a number of factors such as:

• Benign prostatic hyperplasia (BPH, enlarged prostate)
• The condition can be congenital (i.e., present at birth)
• Acquired (develop as a result of injury or disease)

Types of Male Incontinence
The types of urinary incontinence are the same in men and women, stress, urge, mixed, and overflow.

• Stress Incontinence - Occurs when you leak urine during a physical activity like lifting, exercising, sneezing and coughing.
• Urge Incontinence - Occurs when there is overactivity of the muscle surrounding the bladder. This overactivity causes your bladder to contract frequently and creates an overwhelming need to urinate - even if you just went. This condition is often is associated with "overactive bladder" and makes it difficult for you to hold your urine long enough to reach a toilet.
• Mixed Incontinence - A combination of stress incontinence and urge incontinence, in which you have symptoms of both conditions.
• Overflow Incontinence - When your bladder never completely empties, causing urine to leak by overflowing. If nerves are damaged, the signal never reaches the bladder and it stays full. A weakened bladder muscle can have the same result, and the constant pressure of urine on the neck of the bladder can cause dripping and leaking. This is more common in men with who have an enlarged prostate.

Treatment for Male Incontinence
Treatment for male incontinence depends on the type of incontinence and what the cause is. The patient's age, overall health, and severity of the condition are all taken in to consideration. Often, by treating the patients medical condition (e.g., benign prostatic hyperplasia [BPH, enlarged prostate], urinary tract infection [UTI], diabetes) can resolve the incontinence issue.

Treatment may include the following:

• Bladder training, timed voiding
• Electric stimulation
• Medications
• Self-catheterization (particularly for those who have spinal cord injuries)
• Surgery
• Pads and other external devices (disposable or reusable adult diapers, male incontinence drip collectors) may be helpful. Other external devices include penile clamps and compression rings, which can be used to stop urine flow.

Behavioral Therapy
Types of behavior therapy include biofeedback and bladder retraining with timed voiding. Kegel exercises, which can strengthen pelvic floor muscles, also may be helpful. In bladder retraining, the patient keeps a voiding diary of urination and leakage and the physician analyzes the information to help the patient learn to empty the bladder before accidental urine loss occurs.

Biofeedback
Biofeedback is a method that provides you real-time information about activity in your bladder and pelvic muscles. As you gain awareness of these functions, you may be better able to control them. When you relax, your muscles give off signals and these sensors will read the signals. The technician can view them on a computer monitor and you will be able to see if you are using the right muscles.

Neuromuscular Electrical Stimulation
This can be used to cause urinary muscles to contract and to retrain and strengthen weak urinary muscles and improve bladder control. A probe is inserted into the anus and current is passed through the probe at a level below the pain threshold (not felt by the patient), causing the muscles to contract. The patient is instructed to squeeze the muscles when the current is on. After the contraction, the current is switched off for 5 to 10 seconds. Treatment sessions last approximately 20 to 30 minutes.

Medications
The most common medications that may be prescribed are Anticholinergic agents, anitspasmodic medications and alpha blockers.

Surgery
Three types of surgery may be used to treat urinary incontinence in men. In some cases, mild symptoms can be treated using injectable fillers such as collagen or a synthetic material. A device called a male sling can also be used to treat moderate to severe urinary incontinence. This treatment is often performed following prostate surgery and involves surgically implanting a mesh-like material to compress the urethra and reduce urine leakage.

Severe male incontinence that does not respond to other therapies may require an artificial urinary sphincter. This treatment involves a device that has three components that are filled with fluid (e.g., saline): a pump, a balloon reservoir, and a cuff that encircles and closes the urethra.

The cuff is connected to the pump, which is surgically implanted in the scrotum and is activated by squeezing or pressing a button. The fluid in the cuff empties into the reservoir, the urethra opens, and the bladder empties. Fluid from the reservoir returns to the cuff, which again closes the urethra.

Prevention

• Maintain a healthy weight.
• Quit smoking.
• Limit intake of bladder irritants (alcohol, caffeine).
• Exercise regularly.
• Manage existing medical conditions such as benign prostatic hyperplasia, kidney disease, diabetes.

To learn more about male incontinence, click here.