Male Stress Urinary Incontinence

After a Prostatectomy

Stress urinary incontinence (SUI) is an inconvenient and embarrassing condition. That it affects your daily life is an understatement. Fortunately, effective treatment for SUI is available.

Why Male SUI Happens

Stress urinary incontinence is a condition that occurs when physical activity causes the bladder to leak urine. For example, if you have SUI, urine may leak when you sneeze or when you lift a heavy object. Leakage might also occur when you:

Cough
Stand
Have sexual intercourse
Exercise

Two sets of muscles control the passage of urine through the urethra: the pelvic floor muscles and the prostatic sphincter. The pelvic floor muscles support the urethra and bladder, whereas the sphincter prevents urine from leaking by sealing off the bladder’s opening. SUI may occur if either set of muscles stops functioning correctly or becomes weakened.

In men, one of the most common reasons for stress urinary incontinence is a result of prostate cancer treatment. Intermediate to high-grade cancer is often treated with a radical prostatectomy or removal of the entire prostate gland. This typically causes at least temporary urinary incontinence immediately after the procedure. Patients who undergo radiation therapy may also experience incontinence; however, this typically manifests after a delay of a few months.

Modern technology has made treatment options for patients with certain low-grade prostate cancers far more appealing. Just a few years ago, patients would require either active surveillance or an invasive surgical procedure. Today, Georgia Urology offers two minimally invasive procedures – Focal One HIFU and NanoKnife, each of which spares continence and erectile function.

Risk Factors

You may be more likely to develop SUI if you have any of the following risk factors:

Exposure to certain medications
History of surgery to the prostate or pelvic area
Injury to the urethra or the surrounding area
Certain diseases of the central nervous system

Note that more than 80% of post-prostatectomy incontinence cases resolved spontaneously within a year after symptoms began. For those patients who do not regain urinary control, several treatment options are available, and working with a men’s health urologist who specializes in post-prostatectomy recovery is a reassuring next step.

Diagnosing Male SUI

To diagnose SUI, your doctor may perform a physical exam, ask about your symptoms, and/or order various tests. Tests that may be ordered when SUI is suspected include urodynamic studies, a urinary stress test, urinalysis, pelvic ultrasound, and cystoscopy.

Based on the results of these tests, your doctor will recommend various treatment options.

Treatment Options

Depending on the specifics of your condition, you may benefit from one of the following treatments:

Strengthening the pelvic floor muscles: You can strengthen the muscles that control urination by performing Kegel exercises and utilizing biofeedback.
Medication: Certain medications may reduce the symptoms of SUI in men post-prostatectomy.
Behavioral changes: In some cases, behavioral changes may help alleviate SUI, such as reducing fluid intake, maintaining a healthy weight, and avoiding holding your urine.
Surgery: In cases where other treatments cannot effectively eliminate the symptoms of SUI, surgical procedures like an Artificial Urinary Sphincter, Male Sling, or Urethral Bulking may be an option.