What can cause urinary incontinence in men?

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Gladys Y. Ng, MD
Urology
There are several possible causes of urinary incontinence in men. The main cause of urinary incontinence in men is prostate problems. It is often benign prostatic hyperplasia (BPH), or an enlarged prostate gland, which blocks urinary channels causing an obstruction to the flow. Men can get urge symptoms as well as overflow incontinence because the bladder gets full from the obstruction.

In some cases, urinary incontinence is caused by nerve damage. Conditions such as advanced diabetes can result in decreased bladder sensation. People with stroke, Parkinson's disease or multiple sclerosis in the upper tract of the central nervous system can also have urinary incontinence. The inability to signal to the bladder that they need to empty out causes the bladder to get full, causing urge incontinence. People with Parkinson's disease may also have an overactive bladder, which is where the bladder spasms unexpectedly.

People with high spinal cord injuries may have a lot of detrusor overactivity, which is an overactive bladder where the bladder spasms frequently and urine is leaked. People with a spinal cord injury in the lower part of the spinal cord can have an areflex bladder that doesn't signal and just gets fuller and fuller. Men can get incontinence with that when they have to empty out the bladder themselves.

Prostate cancer treatments, either from radiation or prostatectomy, can also cause incontinence. After the prostate is removed, the muscles are weakened and it may take time for them to regain strength. In such cases, men can have transient stress incontinence. Stress incontinence typically happens in men after prostate cancer treatment.
Men develop urge incontinence as frequently as women do with age, says Victor Grigoriev, MD, a urologist at MountainView Hospital. In this video, he describes the causes in urge incontinence in men, which differ from those in women.
Anthony L. Komaroff, MD
Internal Medicine
Incontinence in men can occur when (1) prostate enlargement constricts the urethra, inhibiting the flow of urine, causing difficulty urinating and sometimes causing the bladder to overfill. Prostate surgeries may cause damage to crucial nerves, (2) detrusor overactivity, (3) weakened pelvic floor muscles, or (4) sphincter dysfunction.
Jacob Teitelbaum
Integrative Medicine

Benign prostatic hyperplasia (BPH) - also known as nodular hyperplasia, benign prostatic hypertrophy or benign enlargement of the prostate (BEP) - refers to the increase in size of the prostate in middle-aged and elderly men.

As the urethra (the tube carrying urine out of the bladder through the penis) travels through the prostate, enlargement of the prostate slows urine flow and when severe can totally block urine flow.

Symptoms include urinary hesitancy (delay in starting urine flow), frequent urination, increased risk of urinary tract infections, urinary incontinence, and urinary retention.

The hormone DHT (dihydrotestosterone) regulates prostate size and the ability of the valve controlling flow out of the urethra to relax and open.

In men, stress incontinence is common following prostate surgery.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.