Urinary incontinence in men: causes, treatment, prevention

  • Urinary incontinence in men: causes, treatment, prevention

    Urinary incontinence( synonym - incontinence) is a pathological process that is characterized by an uncontrolled effort of will by the expiration of urine.

    Urinary incontinence is more common in the elderly( more often than 65 years).

    It becomes difficult for people with this pathology to adapt in society.

    Causes of urinary incontinence in men

    Causes of urinary incontinence in men can be varied. Among the most common etiologic factors, it is customary to distinguish the following:

    • adenoma of the prostate;
    • surgical interventions on the genitourinary and pelvic organs( cystectomy, radical prostatectomy, transurethral resection of the prostate, etc.);
    • urinary fistulas;
    • neurological diseases( Alzheimer's disease, strokes, Parkinson's disease, multiple sclerosis);
    • traumatic brain or spinal cord injury;
    • diseases of the organs of the excretory system of infectious genesis;
    • long-term treatment with antidepressants, diuretics, tranquilizers, antihistamines;
    • chronic intoxication( alcoholic, medicamentous);
    • mental illness;
    • stressful situations;
    • congenital anomalies of the development of the organs of the urinary system( epispadia of the urethra - cleavage of its anterior wall, exstrophy of the bladder - complete absence of the wall of the bladder in front and splitting of the urethra);
    • ptosis( descent) of the abdominal or pelvic organs;
    • urolithiasis;
    • age changes in the muscular apparatus of the bladder and urethral lumen.

    Classification of

    It is now customary to identify several types of urinary incontinence in men. They are classified according to the cause that caused the disease:

    1. 1) Stress( involuntary discharge of urine occurs as a result of inferior functioning of sphincters and detrusors of the bladder).This type is provoked by laughter, coughing, sneezing, lifting of weights;
    2. 2) Urgent( occurs as a result of hyperreactivity of the bladder of a neurogenic, infectious or tumor character);
    3. 3) Mixed( a combination of stressful and urgent components);
    4. 4) Postoperative( often the stress character of incontinence prevails, one of the components of which is the failure of the muscular apparatus);
    5. 5) Transient( is a consequence of intoxication of the body or infectious, neurological disease);
    6. 6) From overflow( when there is a violation of the outflow of urine due to the urethral lumen block).

    Clinical picture of pathological process

    Depending on the cause of urinary incontinence, the clinical picture of the disease can be extremely variable.

    Symptoms of the underlying disease can come to the fore and mask the incontinence. As for the "classical" urinary incontinence in men, it manifests itself as follows:

    1. 1) Spontaneous uncontrolled urinary excretion( often drop by drop) in the interval between acts of arbitrary urination. This process is often provoked by coughing, sneezing, straining, lifting weights - factors that promote increased intra-abdominal pressure;
    2. 2) Feeling of incompleteness and incomplete volume of emptying the bladder;
    3. 3) Impossibility to keep urine in imperative urges. The possible complications of
      The untimely treatment of urinary incontinence can lead to a number of unpleasant consequences: social disadaptation, neuroses, depression, decreased libido and erectile dysfunction, diseases of the urogenital system with an active inflammatory component, hydronephrosis, chronic renal failure, arterial hypertension of the vasorenal type.

      Diagnosis of urinary incontinence in men

      Diagnosis of a specific type of disease is only possible after a thorough examination. The basis of advanced diagnostic search includes such laboratory and instrumental research methods as:

      • general blood test, as well as general urine analysis;
      • ultrasound of the pelvic organs and kidneys;
      • urethrocystoscopy - endoscopic examination of the urethra and bladder;
      • urethrocystography - X-ray examination of the urogenital system;
      • uroflowmetry - measuring the flow rate of urine during urination;
      • sphincterometry;
      • cytometry;
      • profilometry;
      • maintenance of a three-day diary of controlled and uncontrolled urine excretion, as well as the ratio of daily diuresis to daytime diuresis;
      • is a "cough" test.
      Read also how to treat cystitis in men.

      Treatment of urinary incontinence in men

      Treatment of urinary incontinence in men is based on the identification and elimination of etiological factors.

      Treatment measures can be both conservative and operational in nature - this is determined by the cause of the disease and the severity of the pathology, as well as the effectiveness of the therapy.

      Among the drugs used in this disease, the most commonly used groups are: antispasmodics, drugs that improve microcirculation, as well as those that are prescribed individually depending on the underlying disease.

      An important role in the treatment of urinary incontinence in men is played by physiotherapy. Among the basic physiotherapeutic procedures should be allocated: magnetotherapy, electrophoresis, electrostimulation of the muscles of the pelvic floor.

      Do not forget about the old, but proven method of strengthening the muscular apparatus of the pelvic floor - Kegl exercises.

      In addition, in this pathology, such treatment methods as: exposure to hypertrophied tissues with microwave radiation, balloon expansion of the urethra, exposure to hypertrophied bladder tissue and / or ultrasonic waves, priuretral injection therapy with collagen can be applied.

      In the case of ineffectiveness of conservative treatment or the presence of certain indications, an operative intervention that can be represented:

      • by canal resection of the prostate gland( this type of operation is performed relatively quickly and has a minimal risk of complications development);
      • by the installation of an artificial sphincter of the bladder;
      • implantation of male loops.

      Prevention of the disease

      In order to avoid the possible development of this pathology, it is recommended to lead an active and healthy lifestyle. In this case, it is important not to forget about the need for regular preventive visits to the urologist( annually).

      Timely diagnosis and treatment of other diseases( including cancer, infectious and neurological) is also an integral part of disease prevention.

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