Tips for Dealing with Urinary Incontinence (For Men)

What is urinary incontinence (UI)?

Urinary incontinence (UI) is being unable to control the flow of urine. This can range anywhere from leaking a little urine when you strain, sneeze, or cough, to a total lack of control of urine. UI is not painful. If you have pain with incontinence, call your care team, as this can be a sign of infection.

UI can be caused by surgery or radiation therapy for cancers in the pelvis (prostate, rectal, gynecological cancers, etc.), or by the cancers themselves, which can damage or weaken the nerves and muscles used to control urine flow. Other things that can lead to UI are obesity, smoking, diabetes, and older age. The main types of UI that may happen after cancer or cancer treatment are:

• Urgency incontinence: When you feel the "urge" to urinate but cannot make it to the toilet in time. This is often due to bladder spasms and may respond to medical therapy.
• Stress urinary incontinence (SUI): Urine leaks with exertion or effort. This can happen when you cough, sneeze, lift something heavy, change position, swing a golf club, or exercise.
• Overflow incontinence: Being unable to empty the bladder completely, which can cause incontinence when the bladder overflows.
• Continuous Incontinence: A complete lack of control of urine flow.

You may have one type of UI or a combination. UI can be a temporary problem that happens right after treatment, or it can develop years after radiation therapy. There are things you can do to improve your bladder health and strengthen the muscles in your pelvic floor (the muscles and supportive tissue located below the bladder).

How can I correct or prevent UI?

• Make a bathroom schedule. Urination often occurs every 3-4 hours. Set times to go to the bathroom to help re-train the bladder.
• Limit how much caffeine, alcohol, carbonated drinks, and spicy foods you take in. These can irritate the bladder, leading to UI.
• Make time for a "just in case" bathroom stop before leaving the house, getting in the car, or going to bed.
• Try not to drink large amounts of fluids before going somewhere where you will not have easy access to a bathroom.

Kegel Exercises

Kegel exercises are used to strengthen the muscles of the pelvic floor, which can decrease UI. The area between your hip bones is the pelvis, and this is where the pelvic floor muscles are located. To strengthen them, you want to tighten the two most important pelvic floor muscles. This can be done by tightening as if you were trying to stop the flow of urine and tightening as if you were trying to stop passing gas.

Start with an empty bladder. Tighten the pelvic muscles and hold for a count of 5. Then relax for a count of 5. Do this 10 times, 3 times per day. Doing the exercises in three different positions (lying down, sitting, and standing) makes the muscles strongest. You can exercise while lying on the floor, sitting at a desk, or standing in the kitchen. You may not feel your bladder control improve for 3 to 6 weeks, so be patient.

Other Tips

• Protect your pelvic muscles by tightening them before a strain, such as sneezing, lifting, coughing.
• Biofeedback helps you become aware of your body so that you can learn to control some of those functions. This can be taught by a physical therapist. Talk with your care team about a plan for physical therapy.
• Small doses of electrical stimulation can be used to strengthen the pelvic floor muscles. Electrodes are placed in the vagina or rectum to stimulate the muscles to contract, in turn "exercising" them.
• In some cases, medications, implants, injections and surgical treatments can be used to treat incontinence. 

When to Contact Your Care Team

If you are having urinary incontinence or pain/burning with urination, call your care provider. There are treatments and actions to help with this condition.