Urinary incontinence in men

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Urinary incontinence is when you find yourself unintentionally passing urine. It’s an issue that many people face in their lifetimes – and it becomes increasingly common with age.

In fact, the NHS estimates that between three and six million people in the UK suffer from some form of urinary incontinence. And while it’s more common in women, many men experience it too.

The charity Prostate Cancer UK explains that one in 25 men aged 40+ experience some form of urinary leakage every year, and estimates that one in three men over 65 have a urinary incontinence problem.

But because issues around incontinence can be embarrassing for some, many people suffer in silence. The British Association of Urological Surgeons (BAUS) tells us that 60-80% of people with urinary incontinence have never sought medical help for the condition – with 35% accepting it as an inevitable part of the ageing process.

However, urinary incontinence can have a significant impact on our quality of life. Those suffering from it can stop pursuing hobbies, exercise, and socialising – and generally become isolated, all of which can impact mental and physical wellbeing.

But it doesn’t have to be this way, because, in many cases, urinary incontinence is manageable and/or treatable.

So, to help break the taboo around male incontinence, we’ve teamed up with MoliCare® from HARTMANN Direct, a provider of incontinence-management products, to bring you more information on urinary incontinence and offer some tips that may help.

As already mentioned, urinary incontinence is when urine is passed involuntarily. It can range from occasionally dribbling a small amount of urine when exerting yourself to a total loss of bladder control. The severity of a person’s incontinence will depend on various factors, such as what type they have and what’s causing it.

But, before we discuss the different types of urinary incontinence, it’s helpful to look at how a fully-functioning urinary system works…

As the bladder fills up with urine, it expands like a balloon. During this process, our urinary sphincter – a muscle that sits just below the prostate and is supported by the pelvic floor muscles – is contracted (or closed). Therefore, it blocks the opening of our bladder so urine doesn’t leak out through our urethra.

Nerves in the bladder wall detect when the bladder is full and send signals to our brain to let us know we need to go to the toilet. Then, when we’re ready, we can relax – or open – the urinary sphincter, contract our bladder muscles, and pass urine.

Like all processes in the human body, retaining and releasing urine is complex, so there are a number of things that can go wrong, which we’ll look at in more detail below.

There are a range of different types of urinary incontinence that are experienced by men. Some of the most common are…

Urge (or urgency) incontinence is when you feel a sudden, strong urge to pee without warning. It’s usually difficult to put off and leads to leakage if there’s not a toilet nearby.

This type of incontinence is typically caused by spasms of the detrusor muscles, which control the bladder. When the detrusor muscles contract, pressure increases in the bladder, which causes urine to leak out unintentionally.

These abnormal bladder contractions can be caused by various things – from an irritated bladder to nerve and spinal column damage.

When we do things like laugh, cough, or sneeze – or when we physically exert ourselves – we put pressure on our bladders. Normally, urine is held in the bladder when this happens because of the urinary sphincter. But if the sphincter or pelvic floor muscles (which support the sphincter) are weak or damaged, they may not be strong enough to prevent urine from leaking out.

The most common reason for these muscles to be weak or damaged in men is due to prostate cancer treatment like prostatectomy surgery – which involves partial or complete removal of the prostate.

To find out more about incontinence as a result of prostate surgery, take a look at this blog post from HARTMANN Direct.

Mixed incontinence is a combination of stress and urge incontinence.

Overflow incontinence happens when we can’t completely empty the bladder. The pressure caused by the remaining urine in the bladder can then lead to leaks.

Not being able to fully empty your bladder can be caused by an obstruction – like constipation or an enlarged prostate – which prevents urine from leaving.

It can also be caused by damaged nerves in the detrusor muscles, which means they can’t fully contract. This sort of damage may occur after bowel surgery or a spinal cord injury. Certain medications can also have an effect on the contractility of your detrusor muscles.

To find out more about overflow incontinence, you might want to have a read of this blog post from HARTMANN Direct.

When someone can’t store any urine at all in their bladder, this is known as total incontinence. It usually means that they’re always needing to urinate and/or leaking.

Like many of the types of incontinence on this list, total incontinence can be caused by a range of factors. For some, it’s due to a problem with their bladder that they’ve had since birth, and for others, it’s because of spinal cord injury, which means messages can’t travel properly from their brain to their bladder.

Functional incontinence is different from all the other types of urinary incontinence because it occurs in people with fully functioning urinary systems. However, incontinence happens because they’re physically unable to get to the toilet when they need it, due to impaired mobility or cognitive difficulties.

To find out more about functional incontinence, why not read this blog post from HARTMANN Direct?

If you experience any urinary incontinence, it’s best to make an appointment with your GP, who may refer you to your local continence service.

When it comes to bladder issues, going to see a GP and talking openly with them is a difficult step for many, and embarrassment surrounding the issue is why so many people keep it to themselves.

However, it’s important that you try to speak openly and honestly with your doctor about your symptoms, as this will help you get the best treatment possible. Try to remember that urinary incontinence is a common issue, and the odds are your doctor has heard it all before.

Firstly, your doctor will ask you questions about your symptoms – such as whether you experience leakage when you cough or how frequently you feel the need to urinate. This will help them to determine which type of urinary incontinence you might be suffering from.

Your GP might also suggest that you keep a bladder diary. This is when the patient is asked to keep a record of things like how much fluid they drink, the types of fluid they drink, how often they need to pass urine, and the number of times they experience incontinence – usually for an interval of at least three days.

If you have a GP appointment booked, you could consider keeping a bladder diary in the meantime, so your doctor has as much information to act on as possible. This NHS pdf has some more guidance on this and a template that you can use, or you can order a MoliCare® Care Pack from HARTMANN Direct, which contains a three-day fluid diary.

As well as asking you to keep a bladder diary, there are various other tests and examinations that a GP might use to diagnose the cause of your urinary incontinence. Some of the most common are…

To check the health of your prostate gland, your doctor may ask to perform a digital rectal examination, which is where they insert their finger into your rectum to feel your prostate.

This type of examination is effective but can be upsetting for some people. To find out more about the procedure, and for some advice if you feel nervous about it, head over to the Prostate Cancer UK website.

Stress test – your doctor may ask you to cough to see if there’s any leakage. This is helpful for diagnosing stress incontinence.

A residual urine test is typically used if your doctor suspects you may be suffering from overflow incontinence.

Dipstick test – urinary tract infections (UTIs) and urinary incontinence are separate issues. However, they’re linked. For example, UTIs may irritate the bladder, leading to spasms and urge incontinence.

So, if your GP suspects your incontinence may be linked to a UTI, they may ask to test a sample of your urine for bacteria.

If these tests aren’t enough to determine the cause of your urinary incontinence, then your GP may suggest further tests – such as a cystoscopy and urodynamic tests.

Getting any medical diagnosis can be scary. But once you find out what’s causing your urinary incontinence, try not to worry, as there’s a wide range of treatment and management options available – from simple lifestyle changes and the use of incontinence products to medical and surgical treatments.

Your doctor will recommend the best treatment and management based on what type of urinary incontinence you have, what’s causing it, and how severe your symptoms are. But, to give you an idea of what to expect, we’ve pulled together some of the most common treatment options below…

There are a number of lifestyle changes that may help to lessen the symptoms of urinary incontinence. Your GP might recommend that you…

Bladder retraining aims to increase the length of time between needing a pee and going to the toilet. Essentially, it helps people to learn how to hold their urine for longer.

For more information, check out this patient information from Sandwell Community Continence Service.

Depending on the severity of your condition, you may be referred to a specialist to determine whether or not you can contract your pelvic floor muscles. If you can, the specialist will get you started on an exercise programme.

However, if you can’t contract your pelvic floor muscles, the specialist may recommend electrical stimulation. To find out more about this, take a look at this patient information from the NHS.

And to learn more about pelvic floor muscle exercises and how you can get started on them at home, take a look at this NHS post.

If lifestyle changes aren’t enough to treat what’s causing your urinary incontinence, then you may be recommended for surgery. There’s a wide range of surgical procedures that are used to help relieve incontinence.

For example, if you suffer from stress incontinence caused by a weak or damaged urinary sphincter, then your doctor may suggest that you have an artificial urinary sphincter fitted.

Alternatively, if it’s urge incontinence, then perhaps sacral nerve stimulation may be recommended. This is when the nerves that carry signals from your brain to your bladder are stimulated using an electrical current.

For more information on surgical treatments for urinary incontinence, check out this page on the NHS website.

If surgery isn’t right for you, or you’d like to avoid invasive treatment, then you might be prescribed medication.

Again, this will depend on what type of urinary incontinence you have, what’s causing it, and how severe your symptoms are.

If you suffer from urge incontinence, then you may be prescribed an anticholinergic (also known as antimuscarinics), which blocks the action of acetylcholine – a neurotransmitter that controls the release of urine.

Or, if it’s stress incontinence you’re being treated for, you may be prescribed duloxetine, an antidepressant that studies have shown can improve symptoms by strengthening your urethra.

To find out more about medical treatments for urinary incontinence, head over to the NHS website.

It’s important to mention here that incontinence products aren’t a treatment for urinary incontinence. However, they can be very helpful for managing incontinence while you’re waiting for treatment.

The two most popular products for men are incontinence pads and pants…

You can choose from different absorbencies suited to specific levels of incontinence (light, moderate, and severe), these ones from MoliCare® are specially designed to fit men. At their core are superabsorbent polymers, which absorb fluid and neutralise any unwanted smells.

Incontinence pads are ideal for those who leak often, have mobility issues, or spend lots of time out and about. This is because they’re easy and discreet to change.

These can be comfier and more discreet than pads, and can be pulled up and down to go to the toilet. However, they’re typically larger, which makes them ideal for those with higher levels of incontinence and /or faecal incontinence.

With a low waistband and a discreet design that means it’s invisible under your clothes, these premium men’s pants from MoliCare® are designed for moderate male incontinence.

Other incontinence products for men include portable urinals, incontinence clamps and sheaths, bed protection, and adapted swimwear.

To browse the full range of MoliCare® male incontinence products, head over to the HARTMANN Direct website using the button below. You can receive 15% off your first order with the code: ‘WELCOME’, and all orders are delivered in plain packaging for full discretion.

You may also be entitled to free incontinence products through the NHS. To see if you qualify, you can ask your GP for information about your local incontinence service. You may also need to be assessed by a healthcare professional to claim this benefit.

Urinary incontinence can be a disruptive issue that prevents us from feeling confident and engaging with the things that we love – such as socialising and hobbies.

However, if you’re suffering from some form of urinary incontinence, we hope this article has shown that you’re not alone and that there are steps you can take to treat the underlying cause and/or manage the symptoms.

For more information and advice on maintaining your wellbeing, head over to our health section. And, to shop for incontinence products, visit HARTMANN Direct’s website.

Have you ever suffered from urinary incontinence? If so, have you found any useful ways to manage it that weren’t mentioned here? We’d be interested to hear from you in the comments below.

Sam McLoughlin is a Lifestyle Writer at Rest Less. He joined the editorial team in 2021 after completing his Master’s degree in English Literature, Culture, and Theory at The University of Sussex. He enjoys writing about careers, books, sports, travel, and pretty much anything that his editor will let him have a crack at, but his favourite part of the job is interviewing inspiring people – from activists and CEOs to later life career changers. In his spare time, Sam enjoys climbing, snowsports, and going to see live music.

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