Male Incontinence

No single treatment works for everyone. Your treatment will depend on the type and severity of your problem, your lifestyle, and your preferences, starting with the simpler treatment options. For some men, surgery is the best choice.

Causes of male incontinence

For normal continence, muscles and nerves must work together to hold urine in the bladder and then release it at the right time.
Nerve problems
Diabetes
Stroke, Parkinson’s disease, and multiple sclerosis Overactive bladder
Spinal cord injury

Prostate Problems

Folowing TURP
Following Radical Prostatectomy
Radiation

Diagnosis

Medical history
Voiding Diary
Physical examination
Urodynamic study
Ultrasound

Behavioral Treatments

For some men, avoiding incontinence is as simple as limiting fluids at certain times of the day or planning regular trips to the bathroom-a therapy called timed voiding or bladder training. As you gain control, you can extend the time between trips. Bladder training also includes Kegel exercises to strengthen the pelvic muscles, which help hold urine in the bladder.

Medicines

Alpha Blockers
Imipramine
Antispasmodics

Surgical Treatments

Surgical treatments can help men with incontinence that results from nerve-damaging events, such as spinal cord injury or radical prostatectomy.

Artificial sphincter: Some men may eliminate urine leakage with an artificial sphincter, an implanted device that keeps the urethra closed until you are ready to urinate. This device can help people who have incontinence because of weak sphincter muscles or because of nerve damage that interferes with sphincter muscle function. It does not solve incontinence caused by uncontrolled bladder contractions.

Surgery to place the artificial sphincter requires general or spinal anesthesia. The device has three parts: a cuff that fits around the urethra, a small balloon reservoir placed in the abdomen, and a pump placed in the scrotum. The cuff is filled with liquid that makes it fit tightly around the urethra to prevent urine from leaking. When it is time to urinate, you squeeze the pump with your fingers to deflate the cuff so that the liquid moves to the balloon reservoir and urine can flow through the urethra. When your bladder is empty, the cuff automatically refills in the next 2 to 5 minutes to keep the urethra tightly closed.

Note:Dr K Ramesh is first person to place a artificial urinary sphincter in Chennai.It is 6 th such case in India.

Male sling: Surgery can improve some types of urinary
incontinence in men. In a sling procedure, the surgeon creates a support for the urethra by wrapping a strip of material around the urethra and attaching the ends of the strip to the pelvic bone. The sling keeps constant pressure on the urethra so that it does not open until the patient consciously releases the urine.

Urinary diversion: If the bladder must be removed or all bladder function is lost because of nerve damage, you may consider surgery to create a urinary diversion. In this procedure, the surgeon creates a reservoir by removing a piece of the small intestine and directing the ureters to the reservoir. The surgeon also creates a stoma, an opening on the lower abdomen where the urine can be drained through a catheter or into a bag.
Currently adjustable male slings are available.