The accidental loss of urine (YUR-in) or having leaking or dribbling, is called urinary incontinence (YUR-uh-nair-ee in-KON-tuh-nence). A lot of men have incontinence after treatment for prostate cancer, but it can happen after being treated for other cancers too. If you have this problem, you are not alone.
Urinary incontinence may only last a short time. In time, the muscles that control the passing of urine can get strong enough to control urination (yur-in-A-shun) again. But incontinence can also be a long-term side effect of cancer treatment. Be sure to talk to your doctor if you are having trouble controlling your urine. There are ways to help.
Incontinence can be caused by more than one problem. Your doctor will ask you questions and do tests to learn the cause of your incontinence. Knowing the type of incontinence will help you and your doctor find the best way to manage it.
Types of urinary incontinence
The 3 most common types of incontinence are:
This is the most common type of incontinence after prostate surgery. It happens when the muscle that squeezes the urethra (yoo-REE-thruh) to keep urine in the bladder is weak or damaged, or the nerves that help the muscle work have been damaged. (The urethra is the tube that carries urine from the bladder out of the penis. The muscle that squeezes to close it is called the urethral sphincter [yoo-REE-thrul SFINK-ter]).
Stress incontinence may cause you to leak urine when you cough, laugh, sneeze, lift heavy objects, or exercise. You may sleep through the night without having to get up to go to the bathroom, but leak when you get up in the morning. Going to the bathroom more often is a way to handle stress incontinence.
When the bladder has a hard time emptying like it should, and more urine is made than it can hold, it’s called overflow incontinence. Overflow incontinence is usually caused by a blockage or narrowing caused by scar tissue. It also may happen when the bladder muscle can’t squeeze well enough to get all the urine out.
Signs of overflow incontinence might be getting up often during the night to go to the bathroom, taking a long time to urinate, or having a weak, dribbling stream with little force. You might pass small amounts of urine but not feel empty. Or you may feel like you have to go to the bathroom but cannot. It may cause you to leak urine throughout the day.
Urge incontinence is also called overactive bladder. It’s when the bladder muscle contracts (squeezes) too often, usually suddenly and without warning, and you can’t control it. This can be caused by a prostate infection or bladder irritation from radiation therapy.
In this type of incontinence, even a small amount of urine in the bladder can trigger a strong need to pass urine. Because you can’t hold a normal amount of urine, you go to the bathroom a lot and may wet yourself if you don’t get there right away. You might feel as if you have a weak bladder, or that liquids go right through you. You might even wet the bed at night.
Treatment for incontinence
If you have problems with incontinence, let your doctors know. You might feel embarrassed talking about this, but remember this is a common problem. Your treatment will depend on the type and cause of the incontinence and how bad it is.
Doctors who treat men with cancer, especially those who treat prostate cancer, should know about incontinence and be able to suggest ways to help, such as:
Kegel (KEE-gul) exercises to help strengthen some of the muscles that help control the flow of urine.. These exercises involve tensing and relaxing certain pelvic floor muscles. Not all doctors agree about their usefulness or the best way to do them, so ask your doctor about doing Kegels before you try them.
Catheters (CATH-it-urs) to collect urine may help. One option is a rubber sheath called a condom catheter that can be put over the penis to collect urine in a bag. For some types of incontinence, self-catheterization may be an option. To do this, you put a thin tube into your urethra to drain and empty your bladder at regular times. Most men can learn to do this. It’s safe and usually painless.
Compression (pressure) devices can be placed on the penis for short periods of time to help keep urine from coming out.
Medicines to help the muscles of the bladder and the muscles that control urine flow. Most of these medicines affect either the muscles or the nerves that control them. These medicines work best for urge incontinence. Other medicines are aimed at treating the cause, such as shrinking an enlarged prostate gland which might be causing incontinence.
Surgery may be used to correct long-term incontinence. Blockages may be removed. Material such as collagen may be injected to tighten the muscle that controls urine flow. If incontinence is bad and not getting better, an artificial muscle controlled by a scrotal pump can be implanted to squeeze the urethra, or a small device called a urethral sling might be implanted to press the urethra against the pubic bone. Ask your doctor if these treatments might help you.
Incontinence products, such as pads worn under your clothing, are available to help keep you active and comfortable. Adult briefs and undergarments are bulkier than pads but provide more protection. Bed pads or absorbent mattress covers can also be used to protect the bed linens and mattress.
When choosing incontinence products, keep in mind the checklist below. Some of these questions might not be important to you, or you might have others to add.
- How much does the product hold or absorb?
- How long will it protect me?
- Can it be seen under my clothing?
- Is it disposable? Reusable?
- How does it feel when I move or sit down?
- Which stores near me carry the products? Are they easy to get?
- How much will it cost? Will my insurance help pay for these products?
Even if your incontinence cannot be completely stopped, it can still be helped. You can learn to manage and live with it so you can do the things you want and need to do.
Coping with incontinence
Incontinence is more than a physical problem. It can disrupt your quality of life if it’s not managed well. Fear, anxiety, and anger are common feelings for people dealing with incontinence. Fear of having an accident may keep you from doing the things you enjoy most – taking your grandchild to the park, going to the movies, or playing a round of golf. You might feel isolated and embarrassed. You might even avoid sex because you are afraid of leakage.
Here are some simple precautions that may help make incontinence less of a problem:
- Empty your bladder before bedtime or before strenuous activity.
- Limit drinks with caffeine or alcohol and citrus juices, which can irritate the bladder and make you have to go more often.
- Because belly fat can push on the bladder, losing weight sometimes helps improve bladder control.
- Quit smoking to reduce coughing and bladder irritation caused by tobacco use.
- Talk to your doctor about all medicines, vitamins, herbs, and supplements you’re taking. Some may affect urine control.
There is no one right way to cope with incontinence. The challenge is to find what works for you so you can return to a normal daily life. Talk with your doctor about the best ways to manage your incontinence. Get the help you need. You may find it helpful to talk with other men who are dealing with incontinence, too. Ask your doctor or nurse about support groups in your area.
Bedretdinova D, Fritel X, Zins M, Ringa V. The Effect of Urinary Incontinence on Health-Related Quality of Life: Is It Similar in Men and Women? Urology. 2016;pii: S0090-4295(15)01186-3.
Urology Care Foundation. What is Urinary Incontinence? Accessed at www.urologyhealth.org/urologic-conditions/urinary-incontinence on March 28, 2016.
National Institute of Diabetes and Digestive and Kidney Diseases. Urinary Incontinence in Men. June 2012. Accessed at www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-incontinence-in-men/Pages/facts.aspx on March 24, 2016.
Last Medical Review: March 28, 2016 Last Revised: March 28, 2016