About Urge Urinary Incontinence In Men

ABOUT URGE URINARY INCONTINENCE IN MEN

In men, the normal bladder and how it works

The bladder is situated in the lower abdomen, to the front of the pelvis.  The back wall of the bladder rests on the lower bowel.  Urine is passed from the bladder to the end of the penis through the urethra (you may call this the bladder tube or water pipe). The urethra is about 20cm (8”) in length.  Where the urethra leaves the bladder (the bladder neck), a strong muscle surrounds it to stop any leakage.  This is the muscle, which you have to relax when you pass urine.

Also around the urethra just below the bladder neck, is the prostate gland.  This is rather like a thick collar, open at the front.  If the prostate gland enlarges, which it does with age, it may tighten around the urethra, making the passing of urine more difficult.

The bladder and bowel are kept in place by muscles, called the pelvic floor muscles.

Your bladder is like a balloon.  When it is full it is like a blown-up balloon, the walls are thin and it is happy to hold the contents until you are ready to let go.  When it is empty, it is like a balloon you have blown up and then gently let the air escape.  Like nipping your fingers around the balloon as you blow it up, the muscle at the bladder neck, helps to prevent leakage, but only if it is strong and well supported, and receiving the correct messages from the brain.

Sometimes you accidentally let go of the balloon half way through blowing it up.  The air escapes quickly and dramatically!  Sadly, this can also happen to the bladder.  With certain illnesses and sometimes in those who are fit and well, the need to empty the bladder is felt urgently, and before the loo is reached, the partly filled bladder suddenly starts to empty making it very difficult to stop the flow of urine.  This is called urge urinary incontinence.

Urge urinary incontinence

Urge urinary incontinence happens when the bladder, although only partially filled, needs to be emptied urgently (called urgency) and the toilet is not reached in time.  With this problem often other symptoms occur, such as having to pass urine more frequently than usual (called frequency), and waking up in the night several times to pass urine (called nocturia).  The leak is often described, as a ‘gush’ of urine and it may be a large volume, which is lost.  Cystitis is an infection, which can cause symptoms of frequency and urgency.

May be made worse by…

Factors, which contribute to urge urinary incontinence include infection in the urine, anxiety, certain medicines, low fluid intake, and drinking particular fluids such as tea and coffee.  Often the actual cause in unknown.  Urgency and urge urinary incontinence can occur in both men and women.

With this type of problem a Bladder Diary may be used.  The volume of urine is measured and recorded each time the toilet is used.  This provides valuable information to the doctor or nurse, and is used to measure progress once treatment is started. The treatment may include tablets from the doctor and referral to a chartered physiotherapist, continence advisor or other specialist.  Pelvic floor muscle exercises are also indicated in the treatment of urge urinary incontinence (see below for a leaflet).

Urge and stress urinary incontinence can occur together, and may be referred to as mixed urinary incontinence.

IMPORTANT:  IF YOU SEE BLOOD IN THE URINE, REPORT THIS TO YOUR DOCTOR.

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