Urinary Incontinence in Men: Causes and Types

Urine leaks — and it's awkward to talk about. But urinary incontinence in men is common, and it's not a sentence: the cause can be found, and the condition can be corrected. Below is what it is, why it occurs, and which doctor to see.

What urinary incontinence in men is

Urinary incontinence is the involuntary release of urine. A person does not control the moment when urine leaves the urethra. It is not a separate disease but a symptom: there is a specific cause behind it.

The bladder is a hollow organ in the pelvis, a reservoir for urine. In men, its capacity is normally 350–750 milliliters. The urge appears when 150–200 milliliters accumulate in the bladder. Urine is held by the internal sphincter — a circular muscle at the outlet of the bladder. If the sphincter, pelvic floor muscles, or nerves do not work properly, urine leaks.

Incontinence is a common problem. There is no need to be embarrassed: you can talk to a doctor about such a symptom.

Types of urinary incontinence

• Stress — urine leaks when pressure is put on the bladder: coughing, laughing, sneezing, lifting heavy objects, physical exertion.
• Urge (imperative) — there is a sudden, strong need to go to the toilet, and some urine comes out before the person can get there.
• Overflow incontinence (chronic urinary retention) — the bladder does not empty completely, urine stagnates, and leakage is frequent. This type is most common in men.
• Total incontinence — the bladder does not hold urine at all: it is released constantly or leaks frequently.
• Mixed, functional, and transient — a combination of types; inability to reach the toilet due to physical or mental limitations; temporary leakage due to infection or a new medication.

Main causes of urinary incontinence in men

Stress incontinence is usually associated with weakening or damage to the muscles that hold urine: the pelvic floor muscles and the urethral sphincter. The bladder may also shift from its usual position.

Urge incontinence most often occurs due to overactivity of the detrusor — the muscle that pushes urine out. Sometimes it is a sign of a urinary tract infection. It can occur in neurological diseases — multiple sclerosis, spinal cord injuries.

Overflow incontinence is often caused by an obstruction at the level of the bladder: it does not empty completely. Causes include tumors, kidney stones, diabetes, and certain medications. In men, prostate problems are a separate factor.

Total incontinence may result from a congenital bladder abnormality, spinal cord injury, or a fistula — a narrow channel between the bladder and an adjacent area.

The chances of encountering the problem are increased by age, obesity, a family history of incontinence, diabetes, prolonged constipation, and smoking. Incontinence is not an inevitable part of aging.

Urinary incontinence in older men

With age, the muscles of the urinary tract weaken, and it becomes harder to hold urine. Urge incontinence is more common in older people. In men, prostate diseases are added to this.

Age is a risk factor but not a cause in itself. It does not fully explain leakage. Some cases are caused by temporary circumstances — infection or medications — and resolve after the cause is eliminated.

How a doctor determines the cause

First, a conversation about symptoms: when and under what circumstances urine leaks, how often, and how much fluid the person drinks.

The patient is asked to keep a diary for several days: how much and when was drunk, when and how much urine was passed, and whether there were any leaks.

Then an examination. The examination may include a rectal examination. Urine and blood tests are ordered, and if necessary, bladder function tests and imaging studies. If the picture is unclear, the patient is referred to a specialist.

When to see a urologist

You should see a doctor for any type of urinary incontinence. It is a common problem, and there is no shame in talking about it: this is where the path to a way of managing the symptom begins.

The doctor will assess whether there is a urinary tract infection: it can be the cause of urge or transient incontinence.

Urine leakage by itself is not a reason to call an ambulance. 103/112 — for life-threatening conditions (for example, signs of stroke or heart attack, serious injury).

This material is for reference: it does not replace a doctor's consultation. The diagnosis is made by a urologist after examination and tests.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer