Urinary incontinence can significantly impact a man’s quality of life. It can make it hard to sit through lengthy meetings and aisle seats become a necessity so there’s an easy escape to a bathroom. It may even become necessary to wear incontinence pads and underwear.
Normally the brain will alert you to use the bathroom when your bladder is only partially full. This gives you fair warning to find a place to relieve yourself. When you use the bathroom a valve call the urinary sphincter opens to allow the bladder to drain. Muscles in the bladder wall squeeze inward to empty the bladder. However, with an overactive bladder, the bladder muscles contract on their own, with very little warning. This results in a powerful urge to urinate.
But what can cause an overactive bladder or incontinence in men? Some men with an enlarged prostate can start to experience urinary incontinence, the involuntary discharge of urine. This can be caused by a range of issues including prostate cancer. Today we are going to discuss the issues involving a enlarged prostate and incontinence.
What is an Enlarged Prostate?
The prostate gland is a gland only found in men. It is about the same size as a walnut and lies just below the bladder. The gland’s job is the make a fluid which forms part of semen. The tube, known as the urethra, passes from the bladder through the prostate gland.
While it is normal for the prostate gland to grow as you get older. More than half of men over the age of 60, and 80% of all men over 80 have enlarged prostate glands. While this can be a sign of cancer, and should be checked, in the vast majority of cases enlarged prostate glands are not cancerous. Non-cancerous enlargement of the prostate is known as benign prostatic hyperplasia.
What is Benign Prostatic Hyperplasia?
Most prostate incontinence issues can be linked to benign prostatic hyperplasia or BPH. This is a condition where the prostate is enlarged but not cancerous. This enlargement can restrict the flow of urine from the bladder, causing uncomfortable and inconvenient urinary symptoms. Whether treatment is needed will depend on how enlarged the gland becomes and what symptoms you have. While there are a range of prostate issues, including benign prostatic hyperplasia, all these conditions have similar symptoms. These include:
- The urge to urinate frequently
- The presence of blood in urine or semen
- Difficulty in urination (pain or burning sensation)
- Painful ejaculation
- Difficulties in having/maintaining an erection
- Pain or stiffness in the lower back, hips and/or upper thighs
- Incontinence and/or leaking or dribbling urine
What is Prostatitis?
Prostatitis is swelling and inflammation of the prostate gland. It often causes painful or difficult urination. Other symptoms include pain in the groin, pelvic area/genitals, and sometimes flu-like symptoms. Prostatitis affects men of all ages but is more common in men 50 and younger. The condition has a number of causes, including bacterial infections, but often the cause cannot be identified. Depending on the cause, prostatitis can come on gradually or suddenly. While it often improves quickly, some types can last for months or keep recurring.
What is Prostate Cancer?
Prostate cancer is the most commonly diagnosed cancer in men. Approximately 3,500 Australian men die of prostate cancer every year. More men die of prostate cancer than women die of breast cancer. Prostate cancer occurs when abnormal cells develop in the prostate. These cells continue to multiple in an uncontrolled way and sometimes spread outside the prostate into nearby or even distant parts of the body. It is generally a slow growing disease and the majority of men with low grade prostate cancer can live for years without symptoms or spread, or the disease becoming life threatening. However high grade prostate cancer can spread quickly and can be lethal.
Why Does an Enlarged Prostate Cause Incontinence?
An enlarged prostate begins to squeeze the urethra and when this happens you might find you have difficulty passing urine. You may also need to go to the bathroom more often during the day and/or night. And because your bladder has difficulty squeezing urine out, it seldom is able to empty completely, meaning it takes a shorter time to fill up, causing frequency issues.
Further, over time, other symptoms can start to occur. Due to the extra work the bladder has to do, the bladder muscle wall can become thicker and less flexible, making it overactive and irritable. This can cause urgency incontinence and nocturnal enuresis. (bed wetting). And enlarged prostate itself can also contain more muscle tissue than previously and any muscles can sometimes contract involuntarily as a result of cold or nervousness. This increases the difficulty of passing urine.
Finally, surgery to ease the narrowing of the urethra may not immediately stop the feeling of urge incontinence. In fact, urgency could get worse for a while until the bladder goes back to normal. This may take a few weeks.
Enlarged Prostate and Incontinence Types
There are a number of incontinence types that can occur due to an enlarged prostate. These include:
One of the most common types of stress incontinence, this can occur due to a weakened pelvic floor. Unless properly exercised, these muscles can weaken over time, losing strength and flexibility. It can also occur as a result of constipation or being overweight. Bladder leakage can occur because of increased abdominal pressure on the pelvic floor and on the bladder, such as when we laugh, cough, lift, sneeze, or exercise.
This is the name we give constant or erratic urine flow. It occurs when the bladder is unable to empty properly, resulting in frequent leakage of small amount of urine, 24/7. It can also be caused by a tumour within the bladder or an enlarged prostate that is either benign or malignant. The bladder does not empty completely which can then lead to urinary retention and/or the risk of a bladder infections.
This occurs due to an overactive bladder. As we discussed before, this is caused by the bladder working extra hard to get past the narrowing of the urethra due to the enlarged prostate. You overactive bladder can tighten without your control, causing the urgent need to urinate.
Also known by it’s medical term “post-micturition dribble” or PMD, this is the loss of a few drops of urine after urination, leaving some urine in the urethra, despite the bladder feeling empty. This can be caused by the weak contraction of the pelvic floor muscles and is common when the prostate is enlarged.
Treatment Options for Incontinence Caused by Enlarged Prostate
There are several treatment options available for threating incontinence caused by the enlargement of the prostate. We recommend you contact your doctor for advice and information. The 6 most common treatments are:
There are certain alpha-blocker medications that can be used with enlarged prostate incontinence. These relax the bladder neck muscles and muscle fibres in the prostate. This makes it easier to empty the bladder.
Bladder retraining is appropriate when surgery is not required. It aims to retrain the bladder to hold more urine to reduce leakage, feelings of urgency, and help manage an overactive bladder.
Pelvic Floor Exercises
Unfortunately, most men are unaware they have pelvic floor muscles. It is important to improve the strength in these muscles as it improves sphincter control and can reduce leakage. These exercises are also recommended pre- and post-surgery.
Diet, exercise, weight, and smoking can all affect the bladder control. Focusing on a healthy diet with less alcohol, sugar, soft drink and caffeine, and more water, can help with bladder issues and frequency.
What type of surgery you may require will depend on your prostate issues. Thankfully there are many options for surgery which you can discuss with your doctor.
There are a wide range of incontinence management products from companies like Holistic Incontinence. We offer a range of pads, adult nappies, incontinence underwear, and incontinence sheets to help you manage your symptoms discretely and with dignity.
Will Incontinence Resolve Post-Prostate Surgery?
It can take up to 6-12 months after surgery for normal bladder function to return and urinary problems to resolve. Many people often report an increase in urge incontinence after surgery, but in most cases this will improve and eventually stop. Only a small amount of men will experience permanent incontinence. Whether your incontinence remains after surgery depends on a number of factors including the surgery type, whether you had cancer, your weight, lifestyle, smoking and drinking habits, and if there were urinary issues pre-surgery.
If you are suffering from incontinence, explore our range of products today. We can help you manage your incontinence issues discretely. Holistic Incontinence also carries a wide range of skin care and sanitation products to help you can get back to your normal life.