One in 10 people over the age of 65 suffers from urinary incontinence. Urine leakage can lead to embarrassment and consequent depression. Most patients believe it is part of the normal aging process and avoid bringing it up with their doctor.
Many others rely on incontinence aids, such as the Friends overnight diaper pants, to offer them some freedom and respite. It can, however, be treated with medication and simple surgeries, so if you know anyone suffering silently, do coax them to consult a doctor.
Incontinence in males:
Although males experience this problem less frequently than women, it still affects about 5mn men in India. There are some general and male-specific causes of incontinence, as follows:
- Age: As one grows older, the bladder’s capacity decreases. It cannot hold back urine for very long. Additionally, the bladder cannot empty itself, so residual urine is left inside, which can leak.
- Enlarged Prostate gland: A swollen prostate can exert pressure on the urethra, leading to stress incontinence in men.
- Prostate cancer: If the prostate is surgically removed, the nerves around the prostate can also get damaged in the process. In rare cases, the urinary sphincter can also get damaged. Consequently, the bladder will experience urge incontinence.
- Chronic pulmonary disease, smoking: In patients of chronic lung disease, or long-term smokers, continual coughing can exert pressure on the bladder, leading to stress incontinence.
- Obesity: Studies show that with every 5 unit increase in the body mass index (BMI), there is a 20% – 70% increase in the risk of incontinence.
- Neurological issues: Certain diseases like Parkinson’s, Alzheimer’s, and multiple sclerosis interfere with the neurological channel between the bladder and the brain. Patients may not recognize when their bladder is full and may end up accidentally relieving themselves.
What treatments are available?
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Depending on what caused the incontinence, the treatment can vary from lifestyle changes to medication and surgery.
Lifestyle changes:
Many patients with incontinence opt for diapers, such as the friend’s overnight diaper pants. They also go for lifestyle changes, such as:
- Regulated fluid intake: If you consume small amounts of fluids at well-spaced intervals, your body will form urine in a predictable amount and at predictable times.
- Training the bladder: Since the sphincter and the bladder are muscles, they can be trained to withhold the urge to urinate. Consult your doctor about the proper techniques to follow.
- Exercising: Exercising can help to control your BMI. Additionally, you can exercise your pelvic muscles to be better equipped at handling incontinence.
- Quitting tobacco: Tobacco smoking is strongly correlated with incontinence. Patients who reduced smoking also reported a decrease in incontinence.
Medication:
- Anticholinergics are prescribed to unwind the taut bladder muscles and give more time to the patients to reach a washroom.
- Alpha-blockers are recommended for men with an enlarged prostate. They work by increasing the urethra’s resistance to the flow of urine, thus treating stress incontinence.
- Sometimes, Botulinum toxin type A (Botox), a relaxant, is injected into the bladder to give patients more time to get to a bathroom when they start feeling full.
Surgery: Doctors may recommend surgery as a last resort:
- Artificial sphincter: An artificial valve is placed under the skin, next to the natural sphincter, which blocks the urethra till it is time to release the urine.
- Sling: Stress incontinence can be caused by a sagging bladder neck. In men, the sling is inserted around the urethral bulb, which lifts the urethra and prevents urine leakage during coughing or sneezing.
In summary:
Urinary incontinence is a common trouble faced by many men. If you or someone you know are experiencing the consequences of incontinence, there is no need to suffer in silence. Consult your doctor to understand the exact cause and find the optimal path to complete relief.