One of the first steps in diagnosing stress incontinence is having a conversation about elimination patterns and any incidents of urinary leakage. It is also essential to discuss medical history, including any past surgeries, current illnesses or chronic conditions, and medications taken regularly.
A thorough physical examination should follow to check the sacral region, and a rectal examination should be performed to identify any physical issues that could affect voiding. Through ultrasound, the doctor will measure the residential volume of urine, and lab work and a PAD test will be conducted to rule out peripheral arterial disease. The doctor may also request patients maintain a voiding diary or a record of foods and beverages consumed, and may provide a short questionnaire to help identify specific patterns in the patient’s habits.
In some cases, further diagnostic assessments might be necessary, especially when conservative therapies have not been effective. Cystoscopy (a narrow tubular instrument is passed through the urethra to examine the interior of the urethra and the urinary bladder) and radiological studies may be performed to determine whether surgery should be considered.
Treatment Options: Conservative Therapy
Once the basic diagnostic assessment is completed, physicians will generally begin by recommending conservative therapy. The goal of treatment is to increase the resistance of urine outflow. Medications for incontinence may be prescribed, or other options might be initiated. These may include:
Pelvic Floor Training
This involves contracting and relaxing the muscles that make up part of the pelvic floor – similar to Kegel exercises for men.
Electrostimulation and Biofeedback
Biofeedback is the use of monitoring devices to display information about the operation of bodily functions that are not usually consciously controlled. This method teaches patients to control these functions consciously.
Botox Injections
Botox injections can help manage stress incontinence symptoms by relieving muscle tension.
Injection of Bulking Agents
A variety of substances can be used to support the sphincter and prevent leakage, including polydimethylsiloxane and dextranomer-hyaluronic acid copolymer.
Other Therapies
If conservative therapies are ineffective or only provide temporary relief, other treatment options might be explored.
Herbal Supplements
Herbal supplements can help some men manage the symptoms and effects of stress incontinence. It is essential to consult with a physician before considering herbal supplements, as their effectiveness will vary from patient to patient.
Collagen Injections
This treatment option aims to fill out the neck and reduce pressure, thus helping manage stress incontinence symptoms.
Paraurethral Balloon Compression
This technique involves the insertion of a balloon into the urethra to compress the surrounding area and reduce leaking.
Installing Slings for Support
A sling can provide extra support to the weakened sphincter, helping it function more effectively and reducing leakage.
Installing an Artificial Sphincter
The goal of an artificial sphincter is to duplicate the natural function of the sphincter and provide a variable degree of resistance. By doing so, it can reduce instances of stress incontinence.
Coping with Stress Incontinence
In addition to medical treatments and interventions, it’s essential for men living with stress incontinence to make lifestyle adjustments that can help manage symptoms and improve overall quality of life:
Maintain a Healthy Weight
Excess weight can place additional pressure on the bladder and pelvic floor muscles. Losing weight through healthy diet and exercise can help reduce the severity of stress incontinence.
Limit Alcohol and Caffeine
Both alcohol and caffeine can have a diuretic effect on the body, increasing the need to urinate. By limiting intake, men with stress incontinence can minimize the risk of accidents and leakage.
Monitor Fluid Intake
While it’s essential to stay adequately hydrated, drinking excessive amounts of fluids before bedtime may cause problems for men with stress incontinence. By moderating fluid intake, particularly later in the day, they can minimize the risk of nighttime accidents.
Conclusion
Stress incontinence in men can be effectively managed through a combination of therapy, medication, surgical intervention, and lifestyle adjustments. Working closely with a healthcare provider to develop and adjust treatment strategies is crucial to optimizing outcomes for patients living with this challenging condition.
