Men develop urinary incontinence if they find themselves unintentionally urinating. This can be very embarrassing, particularly if it happens in public. Male urinary incontinence can occur as men get older, particularly if they have a problem with their prostate gland, which surrounds the urethra. Male incontinence can come in the form of stress incontinence, in which coughing or mild exertion causes urination, or as urge incontinence, which is the persistent need to urinate even when there is little urine in the bladder. There are a number of different treatment approaches for incontinence in men.
Step 1
Strengthen the muscles of your pelvic floor. Your pelvic floor muscles can be strengthened by doing Kegel exercises. The first step for Kegel exercises is to identify the pelvic floor muscles. The National Institute of Diabetes and Digestive and Kidney Disorders recommends pretending that you are trying to keep from passing gas. The muscles that you would tense to attempt to prevent this from happening are your pelvic floor muscles. A standard Kegel exercise is tensing the pelvic floor muscles for three seconds, followed by a three-second rest period. Men trying to strengthen their pelvic floor muscles should gradually work their way up to doing three sets of 10 repetitions three times a day. Start doing Kegel exercises while sitting, and transition to doing them while standing for an extra challenge.
Step 2
Make behavioral changes. Patients can try to retrain their bladder by forcing themselves to delay urination, the Mayo Clinic explains, which can be useful for urge incontinence. Initially, patients will delay urinating for 10 minutes and gradually work their way up to longer times. Patients who have accidental urination may choose to empty their bladder on a regular schedule.
Step 3
Certain medications, known as anticholinergics, can be used to treat male incontinence, the Urology Channel says. Examples include solifenacin and oxybutynin. Tricyclic antidepressants, such as nortriptyline and imipramine, can also be used to treat male incontinence. Men who have developed urinary incontinence as a result of prostate problems may also benefit from medications used to treat benign prostatic hyperplasia, such as alpha-1-adrenergic blockers and 5-alpha reductase inhibitors.
Step 4
Neuromuscular electrical stimulation is another option. With this treatment, a small electrode is inserted into your rectum, allowing a mild electrical current to stimulate the muscles of the pelvic floor. Over time, this treatment will strengthen the pelvic floor muscles, helping improve bladder control. Multiple procedures over several months are needed for this approach to be effective, however.
Step 5
Surgery may be the answer. Sometimes male incontinence is the result of nerve damage, which can occur after a spinal cord injury or a prostate surgery. An artificial urinary sphincter can be surgically implanted if the normal urinary sphincter has become damaged after prostate surgery, the Mayo Clinic explains. This sphincter can be manually controlled, using a pump placed outside the body, which allows the patient to control when urine is able to leave the bladder. A sling can also be wrapped around the urethra, putting pressure on the tube so urine cannot escape until the patient actively attempts to expel urine. Finally, the urinary tract can be rerouted so it drains out through a stoma placed in the lower abdomen. This allows the patient to drain his bladder via a catheter or into a bag.
