The occurrence of sexual incontinence generally involves damage to the urethral sphincter (this muscle is the periurethral ring muscle that controls the function of urination) and the nervous system. In cases such as prostate cancer surgery, trauma, and neurological lesions, the muscle and the nerves that control the muscle suffer damage, the urethral closure function is destroyed, and urine leakage occurs.
Treating incontinence and improving quality of life
Persistent incontinence can limit a patient’s activities, leaving him or her at home, using annoying pads, and dealing with hopelessness and depression, as well as the smell of urine. However, there are now ways to deal with this, allowing patients to return to their lives and regain self-confidence and control.
In men, the sphincter is located immediately below the prostate around the urethra, and its contraction closes the urethra preventing urine from passing out of the bladder, and when relaxed the bladder contracts and the urethra opens and urine is expelled from the body. The urinary mechanism is controlled and fed back by the nervous system. The signal to urinate is first answered with the part of the spinal cord near the tail (sacral medulla), and then the signal is sent up the “highway” through the spinal cord to the brain. The brain then rapidly and often unconsciously processes the signals to produce downstream instructions that travel down the spine to the sacral medulla and then to the pelvis to regulate bladder contraction and sphincter opening and closing. Damage or lesions to the nervous system (central and peripheral), bladder, sphincter and urethra functions directly affect this mechanism.
Types of urinary incontinence
1. Stress incontinence – Incontinence occurs during abdominal exertion, such as lifting heavy objects, sneezing, coughing or working out. It is the most frequent type after radical prostate cancer surgery or after radiation therapy, etc.
2. Urge incontinence – Urge to urinate occurs urgently, but leaks before you can hold it in the bathroom. It can be neurogenic, degenerative, old age, obstruction and many other factors.
3.Functional incontinence – caused by physical mobility problems, such as Alzheimer’s disease, long-term wheelchair, severe skeletal lesions and other inability to successfully complete urination.
4, overflow incontinence – the bladder can not be emptied, too much residual urine will overflow (like a dam after the reservoir exceeds its capacity), such as prostate enlargement caused by urinary tract obstruction.
5, complete urinary incontinence – also known as true incontinence, that is, complete loss of function of the sphincter muscle, urine completely uncontrolled. It is mostly due to surgery, trauma, etc.
You should see your doctor if you experience any of the following
1. Have you ever had involuntary, sudden leakage of urine in your sleep or during the day?
2. Have you ever had urine leakage when you laugh, sneeze, jump, or otherwise exert pressure on your bladder?
3. Do you feel the urge to urinate and then not have time to go to the bathroom?
4. Do you often feel a sudden and urgent urge to urinate?
5.Do you find that your frequency of urination changes?
6.Do you experience urination more than 7-8 times a day?
7.Are you currently using pads or diapers to deal with unexpected urine leakage?
8.Do you feel that the location and convenience of the bathroom is affecting your plans for going out or traveling?
Treatment Options
There are actually a variety of ways for men to deal with incontinence, and identifying the different types of incontinence is key to providing the right treatment. The urologist is the main body of treatment in this area and will deal with it by different means, with surgery often being the last resort.
I. Non-surgical treatment.
1. Mild to moderate leakage, especially after prostate enlargement surgery, can be achieved well by pelvic floor muscle exercises (Kegel training – can be retrieved by typing Kegel and sending it within the public number). By strengthening the pelvic floor muscle tone to play a closed role, at the same time, the impact of surgery will also be reduced in a certain period of time.
2. Absorbent products – pads, diapers, and clothing made of absorbent materials are commonly used.
3.Internal storage device through the urethra – the picture below is a special storage collector, and some men use regular home catheterization to help empty the bladder.
4, external device – penis sleeve external catheter can collect urine, often with the penis clip to block the flow of urine.
5, oral medications – For example, if the prostate is enlarged, taking some therapeutic drugs can relieve the obstruction caused by the enlargement, and those with urge incontinence can take drugs to reduce bladder sensitivity.
Second, surgical treatment.
1, biofeedback/electrical stimulation – aids the patient in sensing and controlling the muscles of the urinary tract
Collagen injections – injected through the urethra at the sphincter to create an augmentation that helps close the urethra
3. Surgery – a variety of surgical procedures, each with its own scope of application. These include prostatectomy to relieve obstruction, implantable “male slings” to strengthen the muscle support around the urethra, and artificial urethral sphincter implants (which mimic the function of a normal sphincter).
Patients and physicians are driven to search for a “permanent solution” to urinary incontinence by pads, restricted mobility and leakage, and by feelings of resistance, but only you and your physician can work together to determine the “best solution”.