Urinary incontinence (UI) — the inability to hold in urine until you make it to a bathroom — is uncomfortable and embarrassing. It affects both men and women, and especially for men, the number of people who develop it increases with age. Approximately 11-34% of older men have some form of the condition, while 2-11% of older men deal with daily symptoms.
Urinary incontinence isn’t a disease, but rather, it’s a symptom of some underlying medical issue that causes loss of bladder control.
At the offices of urologist and men’s sexual health physician Dr. William Brant, located in Salt Lake City, Utah, we understand how difficult it can be to live with UI, and we offer several innovative treatments for it, including minimally invasive sling surgery. The first step, though, is knowing where to go for help. Your best option is coming into our office for a men’s sexual health exam. Here’s why.
The types of urinary incontinence (UI)
There are four primary types of UI:
- Urgency incontinence: a sudden, urgent need to urinate, followed by leakage
- Stress incontinence: leakage brought on by sudden pressure or quick movements, such as sneezing or coughing
- Overflow incontinence: an inability to empty your bladder fully, so it “overflows”
- Functional incontinence: an outside obstacle, such as a physical disability, prevents you from reaching the toilet on time
What are the risks for and causes of urinary incontinence?
The most common risk factors for men developing UI include:
Age
Muscles, including the bladder muscles, weaken with age, which makes holding in urine more difficult. In addition, loss of bladder control may be a symptom of certain diseases or conditions that are more common in older men.
Lack of exercise/obesity
Physical activity can increase stress incontinence, but lack of activity can weaken muscles and increase the risk of weight gain. The pressure of extra weight on the bladder can cause leakage.
History of certain conditions
Diabetes can lead to urine leakage, so can an enlarged prostate, the gland responsible for producing semen, which sits next to the bladder (called benign prostatic hyperplasia or BPH).
Stress or urge incontinence can also be related to untreated prostate cancer, but UI is most often a side effect of prostate cancer treatment.
Neurological issues
Diseases that interfere with your brain’s ability to effectively signal your bladder muscles, including Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis, can also lead to UI.
Other causes of UI in men include:
- Constipation
- Urinary tract infection
- Urinary tract obstruction
- Weak bladder or pelvic floor muscles
- Loss of bladder sphincter strength
- Chronic cough
- Smoking
- Excessive alcohol use
Because the urinary tract is connected to the reproductive system, we can evaluate your issues with a sexual medicine evaluation.
How can a sexual medicine evaluation help UI?
Sexual medicine is a medical field that addresses common issues affecting men’s health, including urinary conditions such as incontinence. Dr. Brant specializes in both urology and men’s sexual health, so he’s well-suited to diagnose and treat such conditions.
During an evaluation, Dr. Brant checks urinary function. He also performs an examination of the prostate gland. If the prostate is enlarged, as in BPH, it can squeeze the urethra, affecting the urine flow. The symptoms vary from person-to-person, but the most common are a hesitant, interrupted, or weak stream; more frequent urination, particularly during the night; urgency, leaking, or dribbling; and urge incontinence.
These lower urinary tract symptoms (LUTS) associated with BPH rarely occur in men under 40, but more than half of men in their 60s, and up to 90% in their 70s and 80s, have some LUTS.
No matter what the cause, Dr. Brant can provide effective treatment. If the symptoms are mild, lifestyle changes, such as avoiding caffeine, alcohol, and spicy food — which all stimulate the bladder — can reduce the frequency of urine leaks.
If the cause is weak pelvic floor muscles, he may recommend you perform Kegel exercises to strengthen these muscles, as they help control urination. They are particularly useful for stress incontinence, but they can also help urge incontinence.
For more severe cases, he may recommend one of two surgical procedures, a sling that wraps around your urethra and bladder neck to help keep the urethra closed, or an artificial urinary sphincter (AUS), a fluid-filled ring around the bladder neck that keeps the urethra shut until you’re ready to void.
As an example, a physical problem that interferes with your arousal or impairs the ability to achieve an erection may cause you anxiety about your sexual abilities. The anxiety then causes a feedback loop, making you hesitant, slowing your response further, and ultimately worsening your ED.
Peyronie’s disease occurs when plaque (fibrous scar tissue) builds up in the penis and causes it to curve during an erection. About six out of 100 men between 40-70 develop the condition; though rare, some men develop it while in their 30s. Symptoms can build up gradually or occur suddenly, but you’re more likely to have them if your blood sugar is high, if you smoke, or if a family member has the disease.
ED is a sensitive subject for most men. But this problem, which causes a persistent inability to achieve and maintain an erection, is more common than you probably think — and it’s treatable. 
If you suffer from 
Diabetes is a metabolic disease that causes high levels of sugar in the bloodstream. In a healthy individual, the hormone insulin moves sugar (glucose) from the blood into the body’s cells, either to be stored or to be used for energy. With diabetes, however, the body has a problem with insulin, so the sugar builds up in the blood.