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Urine is produced in the kidneys and stored in urinary bladder. Urination is the process of emptying the bladder through the urethra that connects the urinary bladder to the external urethral o. There are two sphincters, or valves, that keep the urethra closed to prevent leak: internal urethral sphincter located at the neck of the bladder, and external sphincter located below the prostate gland and is supported by the pelvic floor muscles.
When the bladder is full, stretch receptors in the wall of the bladder send a signal to the spinal cord and the brain. At times when it's not appropriate to urinate, the brain sends back an inhibitory signal to keep the sphincters closed and prevent voiding. When you wish to urinate, this inhibition is removed; the spinal cord instructs the muscle of the bladder to contract and the sphincters to open to let the urine out.
Urinary incontinence is involuntary leakage of urine.
There are several types of urinary incontinence in men:
1. Stress incontinence: urine leakage while sneezing, coughing, laughing or any activity that creates abdominal pressure on the bladder. This usually occurs because the muscles or tissues underneath the bladder are weakened and can no longer support it. In men, this typically happens after the prostate gland is removed for reasons such as prostate cancer.
2. Urge incontinence: need to void that cannot be deferred, inability to hold. This is commonly caused by an overactive bladder, a condition in which muscles in the wall of the bladder contract in an uncontrollable manner. The reason why this happens is unclear but it's likely to involve problems in the nervous system.
3. Overflow incontinence: constant dribbling of urine. This happens when the bladder does not empty properly while voiding making it almost always full and urine overflows. This may be due to weakened muscles in the bladder wall or a blocked or narrowed urethra. In men, the major cause for this type of incontinence is a condition called enlarged prostate or benign prostate hyperplasia, where the abnormal growth of prostate tissue compresses the urethra and blocks urine flow.
Treatment depends on the type of incontinence and severity of symptoms.
1. Lifestyle changes
Limit fluid intake at certain times of the day - such as before going to bed or before a long trip. However, note should be taken to increase fiber content in your meals to prevent constipation.
Cut down on caffeine, alcohol, keep a healthy weight.
Try pelvic floor muscle exercises such as Kegel exercises. This is to strengthen the muscles that support your bladder.
Timed voiding or bladder training therapy: plan regular trips to the bathroom at set times of the day, gradually increase the interval between trips as you gain control.
2. Medication
Depending on the cause of incontinence the following types of drugs maybe prescribed:
Alpha-blockers, 5-alpha reductase inhibitors: for treatment of enlarged prostate.
Imipramine, antispasmodics : these act on nerves to block bladder spasms in an overactive bladder.
3. Surgery
Surgical procedures include:
Implantation of artificial sphincter: this is performed when weak sphincter is the source of the problem.
Male sling: implementation of an artificial support for the urethra. This is usually recommended for those who have had their prostate gland removed.
Other surgical procedures for treatment of enlarged prostate.
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