Men and incontinence

Although urinary incontinence is more common in women, men also suffer from urinary incontinence. As with women, the types of urinary incontinence in men are classified as stress incontinence, urge incontinence, overflow incontinence, or mixed-type incontinence.

The symptoms are similar between men and women. For stress incontinence, there is an involuntary loss of urine during actions that put pressure on the bladder, such as coughing, sneezing, and lifting. The main symptom of urge incontinence is the overwhelming urge to urinate that cannot be stopped. The hallmark of overflow incontinence is the constant dribbling of urine, typically associated with frequent trips to the bathroom and with small amounts of urine. Mixed-type incontinence is simply a combination of two or more types of incontinence and the associated symptoms.

What else do men and women have in common regarding urinary incontinence? We share many similar risk factors and causes of urinary incontinence. These include urinary tract infections, obesity, constipation, dementia, stroke, bladder cancer, weakened pelvic floor muscles, reduced mobility, smoking, alcohol consumption, medications, and caffeine intake.

With so much in common, what is the difference between urinary incontinence in men compared to women? If you are thinking it may have to do with men's ability to stand up when they urinate and write their names on the snow, you would be wrong but not far off from the right answer! The difference is due to male-specific anatomy, specifically the prostate gland.

The prostate is a male gland about the size and shape of a walnut. It surrounds the urethra (the tube that allows urine and semen to flow out of the penis) just below the bladder. The prostate gland commonly enlarges as men age. This can result in squeezing of the urethra, which affects urine flow. This rarely occurs before age 40, but the incidence increases as men age. More than 50% of men in their 60s and up to 90% of men in their 70s or older have enlarged prostates and associated urinary symptoms.

The symptoms vary but the most commonly observed are urgency, hesitation, interrupted stream, weak stream, dribbling or leaking, more frequent urination (especially at night), and urge incontinence. Although these symptoms do not necessarily mean blockage due to an enlarged prostate, it is best to visit your doctor to discuss incontinence.

Your doctor may perform a prostate exam to see whether an enlarged prostate is causing your symptoms. Your doctor will then be able to recommend treatment once they figure out what is causing your urinary incontinence. You should have a routine prostate exam as recommended by your doctor, especially as you get older.

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