Male stress urinary incontinence (SUI) is the accidental leakage of urine caused by sudden physical pressure on the bladder. These leaks can happen when you laugh, cough, sneeze, or work out.
Male SUI most often occurs when the urinary sphincter is impacted during prostate surgery. Treatment may include physical therapy, lifestyle changes, and sometimes surgery.
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What Is Male Stress Urinary Incontinence?
Male stress urinary incontinence (SUI) is one type of urinary incontinence. It happens when you have a weak pelvic floor — the muscles that support the urinary tract.
A sudden movement — jumping, bending over, coughing — can cause accidental urine leaks. Despite the name, this condition is not impacted by mental stressors.
SUI leaks can range from a dribble of pee to a full stream that soaks your clothes. This condition can cause embarrassment or shame and interfere with daily life.
Thankfully, there are many treatment options to help with SUI, from lifestyle changes and nonmedical options to surgeries, all with high success rates.
How common is male stress urinary incontinence?
While stress urinary incontinence is more prevalent in women than in men, it is the most common type of urinary incontinence. Still, the condition is not very common and is mostly seen in men who have undergone prostate surgery (almost 90% of cases).
What causes male stress urinary incontinence?
SUI is not a normal part of aging.
Prostate surgery is a common cause of SUI in men. Doctors often remove part or all of the prostate to treat prostate cancer or a benign enlarged prostate.
The prostate is a walnut-sized organ that sits below the bladder and in front of the rectum. It is located around the urethra, the tube that urine flows through as it exits the penis.
Pressure from the prostate helps hold urine in the bladder. When doctors remove all or part of the prostate, the surrounding muscles may not have enough strength to control urine flow.
Other causes of SUI include:
- Birth defects.
- Nerve injuries.
- Trauma.
Being obese or having a chronic cough can also put pressure on the pelvic floor, making SUI more likely.
Male stress urinary incontinence risk factors
Risk factors for SUI in men include:
- Being overweight.
- Chronic coughing.
- Having prostate or other urinary tract surgery.
- Nerve injuries.
- Smoking.
Complications of male stress urinary incontinence
Complications from SUI include:
- Embarrassment from urine odor.
- Fear of leaking during sex.
- Withdrawal from social events.
The costs of absorbent pads and adult diapers can also be a burden.
How can I prevent male stress urinary incontinence?
Not all cases of SUI can be prevented, but there are some lifestyle changes you can make now to decrease your chances, including:
- Abstaining from caffeine and alcohol.
- Avoiding any surgery of the prostate (if possible).
- Maintaining a healthy weight through diet and exercise.
- Practicing pelvic floor and bladder exercises.
What Are the Signs and Symptoms of Male Stress Urinary Incontinence?
The main symptom of SUI is leaking urine when you:
- Bend over.
- Cough or sneeze.
- Exercise.
- Have sex.
- Laugh.
- Lift something heavy.
In addition, any activity putting pressure on your bladder could cause a leak.
When should I see a doctor about my male SUI symptoms?
If you are experiencing urine leakages during any of the above actions, you should talk with your doctor about SUI.
How Do You Diagnose Male Stress Urinary Incontinence?
Your doctor will ask you about your history and do a physical exam that may include checking your:
- Abdomen.
- Genitalia.
- Prostate.
- Rectum.
Your doctor may ask you to cough, step, or squeeze your pelvic muscles to see if you leak urine. They may also ask for a urine sample.
Tests to diagnose male stress urinary incontinence
To see how your bladder works, your doctor may order:
- Bladder scan — a test that shows how much urine stays in your bladder after you empty it.
- Cystoscopy — a test that moves a tiny camera through a narrow tube to look into your bladder.
- Urodynamic studies — tests that show how well the urinary system holds and releases urine.
Male stress urinary incontinence prognosis
The prognosis for men with SUI depends on several factors, including the cause of their incontinence and any other chronic conditions that may be making the issue worse.
Many men who have had prostate surgery find that over time, their incontinence improves. Targeted movements, such as pelvic floor and bladder exercises, can also be effective. However, every person is different, and health outcomes will vary.
How Do You Treat Male Stress Urinary Incontinence?
Treatment options for male SUI depend on several factors, but your care team will come up with a personalized treatment plan to make sure your confidence and quality of life are high.
Lifestyle changes to treat SUI
Non-medical treatments for SUI include:
- Bladder training. Scheduling bathroom breaks — and gradually increasing the time between them — can help strengthen your bladder.
- Pelvic floor exercises — Your doctor may suggest doing Kegels to regain strength in your pelvic floor. During Kegels, you repeatedly tighten and relax the muscles that stop urine flow. A physical therapist may use biofeedback to help teach you how to do Kegels.
- Managing fluid intake — Under your doctor’s supervision, you may be asked to reduce certain fluids (caffeine, alcohol, soda, etc.) while drinking the recommended amount of water to let symptoms dissipate.
- Wearing an absorbent undergarment — Some men opt for absorbent briefs or incontinence pads, especially after prostate surgery. You can switch to a thinner pad if the leaks lessen.
Non-surgical treatments for stress urinary incontinence
Your doctor may suggest one of the following external devices that don't require surgery:
- Biofeedback — A special sensor inserted in or around the rectum gives feedback as certain pelvic floor exercises are performed. This helps understand if the muscles are contracting correctly and can help fix form and efficiency. Sometimes, electrical stimulation helps strengthen the muscles during the movements.
- Condom catheter — This device fastens to the penis and collects pee in a bag. You can empty the bag into the toilet.
- Penile clip — This clamp restricts the flow of urine from the penis. Your doctor can show you how to use the clip.
Surgery to treat SUI
UPMC's doctors perform the following procedures for SUI:
- Urethral sling — Doctors implant mesh tape to support the urethra, giving you more control over urine flow. This procedure is usually done on an outpatient basis, where you can go home right after surgery, but sometimes an overnight hospital stay is needed.
- Artificial urinary sphincter — For men with severe SUI. Doctors implant an inflatable cuff that helps close the bladder. When you need to pee, you squeeze a pump that is inserted in the scrotum to open the cuff and let urine pass through the urethra. This procedure is also usually done on an outpatient basis, but may require an overnight hospital stay.
As with any surgery, there is a potential risk for infection, and it’s important to listen to your doctor’s recovery instructions.
Is male stress urinary incontinence treatment right for me?
If you have been struggling to control your bladder during certain activities, you may want to look into treatment options for male SUI. There are several treatment options and lifestyle changes you can make to live a happy and full life, even with male SUI. Your care team will discuss the different treatments available and which may work best with your lifestyle.
In addition, if you are feeling ashamed, depressed, or embarrassed about your SUI symptoms, a mental health counselor or therapist may be able to help. Having a safe space to talk about your emotions can help you find confidence while dealing with symptoms. SUI can interfere with daily life and relationships, but you do not have to deal with it alone.
