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Male Stress Urinary Incontinence (SUI)

SUI is the accidental leakage of urine caused by sudden pressure on the bladder. These leaks can happen when you laugh, cough, sneeze, or work out.

Male SUI often occurs after prostate surgery.

Treatment may include physical therapy, lifestyle changes, and sometimes surgery.


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What Is Stress Urinary Incontinence?

SUI is one type of urinary incontinence. It happens when your pelvic floor — the muscles that support the urinary tract — weakens.

A sudden movement — jumping, bending over, coughing — can cause accidental urine leaks.

The leaks can range from a dribble of pee to a full stream that soaks your clothes.

SUI causes

SUI is not a normal part of aging, as some may think.

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.

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:

  • Trauma.
  • Birth defects.
  • Nerve injuries.

Being obese or having a chronic cough can also put pressure on the pelvic floor, making SUI more likely.

Stress urinary incontinence risk factors and complications

Risk factors for SUI in men include:

  • Having prostate or other urinary tract surgery.
  • Nerve injuries.
  • Being overweight.
  • Smoking.
  • Chronic coughing.

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.

Why choose the UPMC Department of Urology for stress urinary incontinence care?

Our urologic doctors and surgeons are:

Stress Urinary Incontinence Symptoms and Diagnosis

The main symptom of SUI is leaking urine when you:

  • Cough or sneeze.
  • Laugh.
  • Exercise.
  • Have sex.
  • Bend over.
  • Lift something heavy.

Diagnosing SUI

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.

To see how your bladder works, your doctor may order:

  • Urodynamic studies — tests that show how well the urinary system holds and releases urine.
  • Cystoscopy — a test that moves a tiny camera through a narrow tube to look into your bladder.
  • Bladder scan — a test that shows how much urine stays in your bladder after you void.

Stress Urinary Incontinence Treatment

The UPMC Department of Urology provides expert care for SUI in men.

Lifestyle changes to treat SUI

Non-medical treatments for SUI include:

  • 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.
  • Bladder training. Scheduling bathroom breaks — and gradually increasing the time between them — can help strengthen your bladder.
  • Wearing an absorbent undergarment. Some men opt for absorbent underpants or an incontinence pad, especially after prostate surgery. You can switch to a thinner pad if leaks lessen.

Non-surgical treatments for stress urinary incontinence

Your doctor may suggest one of the following external devices that don't require surgery:

  • Penile clip. This clamp restricts the flow of urine from the penis. Your doctor can show you how to use the clip.
  • Condom catheter. This device fastens to the penis and collects pee in a bag. You can empty the bag into the toilet.

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.
  • Artificial urinary sphincter for men who have severe SUI. Doctors implant an inflatable cuff that helps close the bladder. When you need to pee, you squeeze a pump that opens the cuff and lets urine pass through the urethra.