A: It can be quite embarrassing for men who end up wetting themselves - they tend to start wearing dark coloured pants and limiting their movements in public to places like shops or restaurants, becoming recluses in fear of public incontinence.
Incontinence is a sudden urge to urinate where men can't stop what they're doing in order to make it to the toilet in time. Men are more prone to urge incontinence. The rates of incontinence in men and women over 60 are quite similar, but men tend to experience it worse than women.
While women in middle age can experience incontinence particularly after childbirth, there's a bit of an awareness problem that men don't suffer with incontinence as often as women do. Incontinence can become an issue for older men.
It's good to have a chat to your GP to see what the causes are. There's quite a few reasons for incontinence, and your GP will likely check that you are emptying your bladder completely to help rule out a prostate issue.
One of the most common things we see is an enlarged prostate which can cause overflow incontinence, where the flow of urine is blocked at the urethra. A urinary tract infection is also a common cause for incontinence.
If the GP can't find a reason for it they will send you to a urologist for a review. Here you would have an ultrasound, blood tests and urine tests to get further information in order to decide on a course of action.
Your treatment will depend on what the cause of the problem is. When the problem is with the prostate, medication would be the first line therapy followed by minimally invasive surgery such as the Rezum (pronounced "resume"), which uses steam to reduce the size of the prostate and is only a day procedure.
If it's found the problem is related to the bladder rather than the prostate, medication is also a good place to start. 70 per cent of men find a medication or combination of medications that works for them.
Failing that, further investigation would be in order and could result in using botox on the bladder, or even a pacemaker-like device to help put an end to the condition.
You don't have to suffer with incontinence; we can fix it.
A strong pelvic floor
Some men can experience incontinence doing things like playing sport or lifting heavy objects - and even when they cough, sneeze or laugh. This is called stress incontinence, and is caused by increased pressure within the abdomen being placed on the bladder.
It can be an issue for those who have had prostate surgery, but often resolves itself within a year of surgery. Undertaking pelvic floor strengthening exercises can help speed up this process.
The pelvic floor contains muscles and tissues which support a man's bladder and bowel and can be weakened through gaining weight, ongoing constipation and a lack of physical fitness. Every man can benefit from pelvic floor exercises, but those with bowel or bladder problems should seek instruction from a physiotherapist or GP on the most appropriate training method.
The Continence Foundation of Australia (National Continence Helpline 1800 330 066) has information on the benefits of pelvic floor exercises for men and women, as well as exercise guides provided by the Australian Physiotherapy Association.
- Answer is provided by Brisbane urologist Dr Jo Schoeman, through HealthShare, a digital company dedicated to improving the health of regional Australians. Submit questions, and find more answers, at healthshare.com.au.
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