Urinary incontinence is one of the most common problems that affect the elderly and affect their lives and activities. In this article, learn about the most important causes of urinary incontinence in men and ways to treat it in Turkey.
Urinary incontinence in men
Urinary incontinence is defined as the loss of the bladder's ability to properly store urine resulting in unintended leakage of urine through the urethra.
Incontinence is not a disease in itself but rather a symptom of a problem in the urinary tract.
Urinary incontinence in men is a common and embarrassing problem statistics It indicates that 3.4 million men in the United States of America suffer from urinary incontinence and have difficulties in adapting to society. Swedish study The prevalence of enuresis in men is estimated at 22.6% compared to 49.0% in women.
There are several types of urinary incontinence in men and women, some of them are more common in men than in women, the prevalence of this condition increases with age, but it is not inevitable and is usually treatable.
Urinary incontinence needs serious medical treatment when it affects daily activities and hinders the person from performing his work. Simple changes in daily behaviors and diet may be sufficient to treat the symptoms of incontinence and may require special medical procedures to treat incontinence in men.
Urinary incontinence symptoms
Urinary incontinence is itself a symptom of another problem or underlying disease. Urinary incontinence may be short-lived indicating pathological or therapeutic injury or it may be long-term (chronic) characterized by a gradual onset.
There are types of urinary incontinence that may cause distinct symptoms. In addition to involuntary urinary leakage, types of chronic incontinence include:
- stress incontinence: Occurs when external pressure on a weak bladder is the cause of urine leakage. External pressure may come from coughing, sneezing, laughing, or lifting heavy objects.
- Urgency incontinence: It occurs when you feel a sudden, strong urge to urinate frequently, you may not be able to get to the bathroom in time and the bladder shrinks on its own and leads to involuntary leakage of urine.
- Mixed seamless: This type of incontinence combines stress incontinence and urge incontinence.
- Overflow incontinence: It is characterized by the presence of a desire to urinate, but you can only urinate in a small amount, which leads to failure to empty the bladder and leakage of urine later, due to the presence of obstruction or obstruction in the bladder outlet, as in an enlarged prostate.
- Career smoothness: This type of incontinence is caused by a physical or mental imbalance that prevents you from getting to the bathroom in time.
I have proven Studies That one out of every five men who have symptoms of incontinence seek medical attention only, and that despite the availability of appropriate treatments, the percentage of men who seek care is estimated at half Women with urinary incontinence who seek care.
Causes of incontinence in men
Different types of urinary incontinence have different causes. Certain daily habits, underlying illnesses, or physical problems may cause incontinence in men. The most common include: Reasons for uncontrollable urination in men:
Prostate related problems
Prostate problems and the operations needed to treat them are the most common cause of urinary incontinence in men, as the prostate increases in size with age.
The prostate is often enlarged due to benign prostatic hyperplasia in middle-aged people, and the enlargement may be caused by prostate cancer (The most common cancer in men), especially at advanced ages.
When the prostate enlarges, it presses on the urethra, thus affecting the flow of urine, causing weak urine output and polyuria, and urine leakage and overflow incontinence may occur.
Urinary incontinence in men can be caused by damage or weakness in the urinary sphincter after prostatectomy, resulting in stress incontinence that provokes increased pressure on the bladder.
Urinary incontinence may be after Prostate surgery Temporarily, but in other cases urinary incontinence persists and requires special attention to treat.
Conditions that lead to neurological damage
Nerves alert a person when his bladder is full and control the work of the bladder muscle and urinary sphincters, so normal urination requires the integrity of both nerves and muscles, and any disease or injury in them may result in urinary problems.
Neurological damage includes:
- Parkinson's disease
- Alzheimer's disease
- Cerebral infarction
- Multiple Sclerosis
- the disk or Hernia of the nucleus pulposus
- Spinal cord injuries
- Cutting the nerves supplying the bladder and sphincters during surgery (especially prostate surgery)
Urinary problems that accompany nerve damage vary according to the location of the injury. Urge incontinence or overflow incontinence may occur, and a condition called an overactive bladder may result. That is, the bladder contracts involuntarily and is no longer under the patient's control.
Talk to your doctor to find out its exact neurological causes.
The amount and quality of fluids drunk
Certain types of beverages can stress the urinary system. Coffee and alcohol, for example, have a diuretic effect, and limiting their drinking may help better bladder control.
Despite this, drinking fluids is necessary to maintain the health of the urinary system, but on condition that fluids are not over-introduced into the body because this aggravates bladder control problems.
Being overweight can exacerbate the problem of urinary incontinence. When fat accumulates in the body, the bladder will feel more pressure, making the obese person feel the need to urinate more often and cannot hold his urine for long periods.
Methods for diagnosing urinary incontinence in men in Turkey
The doctor will ask you about your medical history and symptoms you are currently complaining about, and will also clinically examine you with some urine tests, this is usually enough to help the doctor reach a diagnosis and find out the type and cause of your incontinence.
Your doctor may ask you to record the amount of fluids you drink, the time and number of urinations, and an estimate of the amount of urine each time for several days. It is important to tell the doctor if you have a urinary urgency or an incontinence event and have not been able to get to the bathroom in time.
Your doctor may need to measure the force of urination with special devices that measure the maximum flow of urine and mean flow rate and then calculate the amount of urination and the amount that remains in the bladder after urination (urinary dregs), to confirm the type of incontinence you have and to detect the presence of blockage in the urinary tract as well.
Treatment of urinary incontinence in men in Turkey
Relies Urinary incontinence treatment for men Primarily based on the cause and type of their incontinence, treatment may include making changes in daily life or taking medications or both, in some other cases modern methods or surgeries are recommended in order to treat incontinence in men.
Behavioral changes in daily life for men's urinary incontinence treatment
Your doctor may advise you to:
- Go to the bathroom several times a day and don't hold your urine for long periods. Choose to wear clothes that can be removed easily and clear the way to the bathroom so you can get there quickly before the urine leaks.
- Drinking enough fluids and following a healthy diet will help lose weight and restore bladder control. Choose healthy, natural drinks and stay away from soda, alcohol, coffee and tea.
- Train your bladder by holding urine and preventing it from leaking after you feel a urinary urgency. Try starting with ten minutes and then gradually increasing the time. This will help you extend the period between feeling the urge to urinate and urine leakage so that you can reach the bathroom before you wet your clothes.
- Kegel exercises can help strengthen the pelvic floor muscles that help hold urine. This method is especially effective for stress incontinence, but it can be helpful in urge incontinence.
- Use a diary to record daily urination, symptoms associated with urination, and urinary incontinence if they occur. Doing this will help your doctor choose the best treatment for urinary incontinence if changes in daily habits aren't enough to treat incontinence.
Drug treatment for urinary incontinence
Drug treatments are often not helpful in treating stress incontinence. On the other hand, there are many drugs that are used to treat urge incontinence.
Incontinence medications for men include:
- anticholinergics;: This drug class includes many drugs, such as oxybutynin, that relax an overactive bladder and may be helpful in urge incontinence.
- Mirabegron: This medicine relaxes the bladder muscle, increasing its ability to absorb urine and increasing the amount of urination, which helps to empty the bladder better. This medicine is used in the treatment of urge incontinence in particular.
- Alpha blockers: Like tamsulosin, it relaxes the bladder neck muscles and muscle fibers in the prostate, facilitating emptying of the bladder. Alpha-blockers are used to treat urge incontinence and overflow incontinence in men with an enlarged prostate.
We advise not to follow people who talk about Herbal treatment of urinary incontinence in men Because so far there is no single evidence of their effectiveness.
Modern techniques for the treatment of urinary incontinence in men in Turkey
These are non-surgical treatments useful in treating types of urinary incontinence, including:
- Electrical Stimulation for Male Urinary Incontinence
Electrical stimulation is done with electrodes temporarily placed in the rectum to strengthen the pelvic floor muscles. Gentle stimulation may be effective in the treatment of stress incontinence and urge incontinence. This procedure must be repeated several times over a period of months.
- Bulking agents
It is an endoscopic procedure in which artificial materials are injected under the lining of the urethra to narrow the lumen and help hold urine and prevent leakage. Therefore, it is used in the treatment of stress incontinence.
This procedure can be performed on an outpatient basis and does not require any surgical incisions, but its success is limited compared to other more minimally invasive procedures such as surgery, knowing that it can be repeated more than once.
- botulinum toxin type A (Botox)
It can be injected into the bladder muscle to help relax it. This procedure may be helpful for people with overactive bladder or urge incontinence and is often used when other treatments have failed.
- Sacral nerve stimulation
Sacral nerve stimulation, also known as sacral neuromodulation, is indicated when urge incontinence is caused by too frequent contraction of the bladder muscle (neurogenic bladder).
The sacral nerves control the contraction of the bladder muscle. When these nerves are stimulated with moderate electrical impulses, the contraction of this muscle is affected, which prevents urinary incontinence.
In this procedure, a small device (neural transducer) is implanted under the skin of the lower back near the site of the sacral nerves. The device sends electrical signals to these nerves.
Surgical treatment of urinary incontinence in men in Turkey
In the event that other non-invasive procedures fail, surgery may be resorted to as a last resort. Surgical procedures to treat urinary incontinence in men include two types of operations. Studies Both procedures have contributed to improving the symptoms of urinary incontinence:
Treatment of urinary incontinence in men with a male sling
The doctor uses tissue or a synthetic material to create a loop around the urethra and bladder neck, which helps keep the urethra closed during coughing or sneezing.
The male carrier provides greater urinary retention in patients who complain of mild stress incontinence, knowing that this minimally invasive technique can be performed and discharged from the hospital on the same day for most patients.
Artificial urinary sphincter
An artificial sphincter implant is the gold standard for stress incontinence in men and is effective in treating moderate to severe incontinence.
In this procedure, a small fluid-filled ring called a cuff is implanted around the neck of the bladder in order to keep the urinary sphincter closed until the need to urinate.
When urinating, the patient presses a pump valve implanted under the skin of the scrotum to empty the ring of fluid and allow urine to exit the bladder. The fluid moves and collects in a tank temporarily until the patient finishes urination, then returns to fill the ring and closes the sphincter again.
Men's urinary incontinence tools and products
When all previous treatments fail to stop incontinence, you can use special products to relieve the discomfort and embarrassment associated with urine leakage, including:
- Diapers and protective pants: These are underwear specially designed to absorb urine leaking from incontinence. It is noted that this product does not stop incontinence, but it helps to live with it and prevent urine from reaching outer clothing.
- Catheters: Catheters help empty the bladder completely, so doctors recommend using this tool in the event of urinary incontinence after urination. A flexible tube is inserted through the urethra several times a day to drain urine from the bladder. The patient must be aware and familiar with the method of applying the catheter for safe use.