What is urinary
incontinence?
Urinary incontinence is simple voluntary loss over urine
control. The patient keeps voiding some amount of urine from time to time which
is not under his control and thus can come across with embarrassing situations.
Incontinence is of four types: stress on bladder, overflow,
urge and functional incontinence.
What are the primary
causes for incontinence in males?
- Enlargement of prostate gland.
- Injury to head and spinal cord resulting in loss of bladder control.
- Neurological diseases like benign tumors or degenerative diseases like Parkinson or multiple sclerosis.
- Advanced infections of urinary tract
- Organic brain damage with aging leading to mental confusion.
- Toxins like excess alcohol
- Medications which sedate and relax the bladder muscles.
What are the various means
of male incontinence treatment?
External protective devices
These include bed pads, disposable diapers, drip collectors
and underwear liners which prevent wetting of clothes. Other external devices
are penile clamps and compression rings which stop constant urine flow to some
extent. With these devices, patients should adhere to voiding schedule and use
them properly to avert serious penile and urethral damage, swelling or
obstruction.
Neuromuscular
electric muscle stimulation
Stimulating the nerves of pelvic floor like the pudendal
nerve can trigger good contractions in the detrusor muscle of the bladder and
sphincter. As the modified electric current passes in the body through the
probe, muscles begin to contract and the patient is also asked to squeeze with
every wave of current.
Behavioral therapy
Behavioral therapy majorly includes bladder training with
timing to pass the urine. Patient is taught Kegel exercises and an analysis is
drawn from his everyday voiding and leakage.
Apart from this, simple modality called biofeedback, by
recording small electrical audio/visual signals with each contraction motivates
patient to contract and align his pattern of urine control once again.
Medications
A combination of medicines can be used to relax bladder
contractions that are involuntary, improve bladder function and treat the
incontinence.
Anticholinergic
agents: They reduce muscle spasms by their anti spasmodic effects on the
bladder and are good for urge urinary incontinence treatment.
Tricyclic anti
depressants: These medicines also reduce spasms of bladder muscles by
blocking the unwanted nerve impulses known to tighten the musculature.
Alpha -1 adrenergic
blocking drugs: These are specialized class of drugs given for treating
benign prostatic hypertrophy which compresses urethra and can cause
incontinence.
Alpha reductase
inhibitors: They chiefly retard the production of male growth hormones
which are likely to cause BPH and incontinence.
What are the side
effects of these drugs?
Collectively the side effects include dry mouthy, dizziness,
headache, vision disturbances, fatigue and erectile dysfunction.
Surgical management
of incontinence
Initially, injectible fillers can be used to reduce bladder
pressure. In extreme cases, prostectomy can be done and in some cases,
artificial urinary sphincter can be placed to control urine output.
How can it be
prevented?
- Quit smoking.
- Avoid bladder irritants like alcohol and caffeine.
- Exercise every day.
