Stress Urinary Incontinence in Men

Stress urinary incontinence (SUI) is something most women are familiar with. In fact, by age 60, one in three women have experienced the condition that causes involuntary or accidental leakage of urine.

But what about men? While not as common, stress urinary incontinence in men is something that can happen.

What Is Stress Urinary Incontinence?

When all parts of the system are functioning as intended, the urinary process is supposed to work like this:

The kidneys make urine by cleaning our blood and removing waste and excess water, which is what makes up urine. The urine drains down through the ureters into the bladder. The bladder, which stores urine, has muscles around it that contract when we release urine. The urethra, a tube that runs from the bladder floor to the external opening for release, has sphincter muscles that keep it closed until you are ready to release urine. When you want to release urine, the sphincter relaxes, and urination occurs.

In someone with SUI, the pelvic floor, which is a “sling” of muscles that supports the pelvic organs, including the bladder and urethra, is weakened and does not give the proper support.

Additionally, SUI can be due to a weakened sphincter muscle around the urethra, making it more difficult to hold in urine until you are ready to release. With SUI, leakage also may happen when you have sex.

Not all urine leakage is SUI. Urge incontinence (UI) is a sudden strong urge to urinate and an inability to get to a toilet in time. UI may also include urine leaks that occur without warning. Overactive bladder is considered a type of urge incontinence.

Some people have both SUI and UI, which is called mixed incontinence.

Impacting Daily Life

SUI can decrease a person’s quality of life. Many are afraid to stray too far from convenient access to a toilet.

Some also may avoid activities they once loved for fear of embarrassment. Accidental leaks when participating in a sport or hobby with friends can make for uncomfortable situations, so many people would rather not tempt fate.

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Causes of Stress Urinary Incontinence in Men

SUI can be caused by a number of factors but the biggest cause of SUI in men is from a procedure to remove an enlarged prostate. Post-prostatectomy incontinence is likely caused by damage to the sphincter muscle around the urethra.

For men, other causes of SUI can include:

  • Obesity.
  • Frequent and heavy lifting, pushing, or pulling, as required by certain jobs.
  • Frequent straining to have a bowel movement.
  • Chronic coughing.
  • A side effect of aging.

Symptoms of Stress Urinary Incontinence

Leakage is the main symptom of SUI and happens when pressure is put on the bladder. Leakage can happen during physical activities like golf or gardening, or simply when laughing, sneezing, or bending over to tie your shoes.

Depending on the severity of damage, leakage can vary from a slight leak to a full flow, enough to wet underwear and even pants.

Treatment Options and Management

For men with low to mild leakage, doctors may recommend simple lifestyle changes and exercises to help manage SUI. Those can include:

  • Losing weight to put less pressure on your pelvic floor.
  • Changing your diet to improve bowel habits and prevent constipation. Constipation can put extra pressure on the bladder. Adding high-fiber foods, such as more fruits and vegetables, cutting back on carbs, such as pasta and bread, and drinking more water can help with constipation. The addition of a stool-softening supplement also may be recommended.
  • Cutting back on caffeine and alcohol, which irritate the bladder and make SUI worse.
  • Reducing chronic coughing by quitting smoking, or better managing asthma or bronchitis.
  • Strengthening your core (abdominal) muscles and pelvic floor with exercises.

Surgery also may be an option for more serious cases of SUI. Surgery typically is recommended for men who are using fewer than five pads per day to manage leakage. There are two types of surgery for urinary incontinence:

  • Urethral sling procedure. This procedure involves a synthetic tape that is placed around part of the urethra, slightly compressing it, and moving it to a new position. This is minimally invasive and often can be done as an outpatient procedure.
  • Artificial Urinary Sphincter (AUS). This procedure is recommended for men with significant urinary sphincter damage and severe leakage. An AUS is intended to replace a normally functioning urinary sphincter and is made up of three parts: a cuff, which helps close the urethra; a pump, placed inside the scrotum; and a pressure-regulating balloon, placed inside the lower abdomen. To urinate, you squeeze the pump, allowing the cuff to open for 1 to 2 minutes while you urinate.

Urology at UPMC

If you need specialty services for SUI or any other urinary tract issue, find a urologic surgical specialist at UPMC.

About Urology

The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs, including erectile dysfunction, kidney stones, urinary incontinence, prostate cancer, and more. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. To find a provider near you, visit our website.