Urinary Incontinence Treatment

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No single treatment works for everyone. Your treatment will depend on the type and severity of your problem, your lifestyle and your preferences. Many men regain urinary control by changing a few habits and doing exercises to strengthen the muscles that hold urine in the bladder. If these behavioral treatments do not work, you may choose to try medicines or a continence device—either an artificial sphincter or a catheter. For some men, surgery is the best choice.

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. 

Reducing or eliminating existing medications for other issues

Before prescribing a medicine or other treatment for incontinence, we may consider changing a prescription you already take. For example, diuretics are often prescribed to treat high blood pressure because they reduce fluid in the body by increasing urine production. Some men may find that switching from a diuretic to another kind of blood pressure medicine takes care of their incontinence. If changing medicines is not an option, we will treat your incontinence as best as we can with additional medication or other treatments while you remain on the medication that may be causing or increasing your UI. 

Prescribing Medications to Treat UI

Medications to treat UI work in different ways to affect bladder control. Some medications help prevent incontinence by blocking abnormal nerve signals that make the bladder contract at the wrong time, while others slow the production of urine. Others relax the bladder or shrink the prostate. 

  • Alpha-blockers are used to treat problems caused by prostate enlargement and bladder outlet obstruction. They act by relaxing the smooth muscle of the prostate and bladder neck, allowing normal urine flow and preventing abnormal bladder contractions that can lead to urge incontinence.
  • 5-alpha reductase inhibitors work by inhibiting the production of the male hormone DHT, which is thought to be responsible for prostate enlargement. These medications may help to relieve voiding problems by shrinking an enlarged prostate.
  • Imipramine relaxes muscles and blocks nerve signals that might cause bladder spasms.
  • Antispasmodics work by relaxing the bladder muscle and relieving spasms. 

Surgery

If the other options fail, we may be able to treat your UI with surgery. Dr. Francis Schanne leads reconstructive Urology surgery at Urologic Consultants. He offers nationally recognized expertise in helping men who experience UI, especially after cancer treatment or trauma. 

Surgical treatments listed below can help men with incontinence that results from nerve-damaging events, such as spinal cord injury or radical prostatectomy. Robotic prostatectomy is less likely to damage nerves and cause UI. Robotic surgery can often be used to eliminate UI as well.

  • Artificial sphincter

An implanted device 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.

An implanted device 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. 

  • Male sling

We create 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 you consciously release 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.