Men & Incontinence

When a bloke is fully continent, he has no real understanding of what losing bladder control would feel like. No idea of how it might impact his self-esteem, his masculinity, his social opportunities, his intimate relationships, and his ability to work.

Full control of our waterworks is something we take for granted as a grown up. Probably the biggest challenge we face is urgency after a few beverages or a dribble after emptying once we put the equipment away.

Our urinary system is remarkable bit of kit. Twenty-four hours of every day our kidneys filter circulating blood to remove toxins, waste products, excess fluid and more. The removed fluid drains into our bladder where it accumulates until we get a signal to empty. We get the first signal before it is critical and can choose to delay emptying, but the second and third signals are more powerful and harder to resist. The ability to delay until emptying is convenient and appropriate is to be continent. In control.

What is a family health history?

Your family health history (aka family medical history) is a record of your current and past illnesses and health conditions. It is also a record of your family’s health history which includes your parents, siblings, children and other blood relatives, including grandparents and aunts and uncles.

Causes of male incontinence

Firstly, you are born incontinent. Continence is a learned skill. Once learned you will be OK until something messes with it, like :

• Disease – kidney or bladder disease (including cancer), diabetes, a stroke or dementia. Neurological diseases such as Parkinson’s or Multiple Sclerosis can reduce your awareness or control.

• Surgery – for bowel problems, lower back or prostate gland (more on this one later).

• Radiation treatment for bowel or prostate cancer.

• Muscle weakness associated with ageing plus less activity.

• Obesity – excess weight on the bladder testing your continence

• Chronic respiratory disease – years of coughing overpowering your bladder control.

• Urinary Tract Infection(s) – causing bladder irritability and urgency.

• Constipation and straining – difficulty moving your bowels and straining repeatedly can damage your urinary control muscles.

• Drug side-effects or interactions between medications for other problems.

Most cases of incontinence in men can be resolved by treating the underlying condition. Antibiotics for infections, stool softeners and dietary modification for constipation, a general strengthening program for weakness, surgery for pain or tumours may help (except for prostate cancer). For these options to come into play a man must report his urinary incontinence to his medical team. Otherwise, it will progress and possibly become persistent and disabling.

Prostate cancer is a special case, because the treatment to resolve the cancer may lead to incontinence at least for a while. Pelvic floor physiotherapy may improve urinary control and failing that there are surgical options to ‘sling’ the urethra or implant an artificial sphincter to control urinary flow.

Urinary incontinence is not just a plumbing problem. As we use the same plumbing with our sexual function it can impact on a man’s perception of his manliness. The possibility of incontinence during intimacy may impact a relationship both physically and emotionally.

Until any incontinence resolves, there are a range of pants and pads designed for men to absorb and contain bladder leakage. This may be a temporary phase following prostate removal, or a permanent strategy due to stroke or other disease process.

Wearing incontinence aids may challenge a bloke’s masculinity. It can make work or social gatherings unavailable or awkward, which affects his self-worth. My patients often tell me of their embarrassment and how they worry about the smell, pad disposal, having enough on hand and having to plan their day around toilet opportunities.

Incontinence can be uncomfortable, inconvenient and at times embarrassing. But it is not fatal and need not be demasculinising. It is just another bump in the road of life for some of us; something to be acknowledged, treated, managed, then moved beyond. This is best done with family and medical support rather than hiding and denying there is a problem.

Blokes are problem solvers but find their own personal problems the most difficult to get a handle on. Reach out, ask for help, and be prepared to do the work required to solve your leakage problem.

If your urinary incontinence resulted from treatment for prostate cancer, you may find value in my book: Prostate Recovery MAP – Men’s Action Planis a five-stage program to help men navigate a return to full bladder control.

Prostate Recovery MAP – Men’s Action Plan
Author: Craig Allingham
Publisher: Redsok
ISBN: 9780987076687

www.prostaterecoverymap.com