Tips for Dealing with Urinary Incontinence (For Men)

What is urinary incontinence (UI)?

Urinary incontinence (UI) is when you cannot control the flow of your urine. UI can be leaking 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 this can be a sign of infection and you should call your care team.

UI can be caused by surgery or radiation therapy for cancers in the pelvis (prostate, rectal, gynecological cancers, etc.). It can also be caused 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.
• Stress urinary incontinence (SUI): Urine leaks with exertion (movement) or effort. This can happen when you cough, sneeze, lift something heavy, change position, swing a golf club, or exercise.
• Overflow incontinence: When you are 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 or more types of UI. UI can be a problem that happens right after treatment, or it can happen years after therapy.

What can I do about UI?

There are things you can do to improve your bladder health and strengthen the muscles in your pelvic floor (the muscles and supportive tissue found below the bladder).

• Make a bathroom schedule. Urination often happens every 3-4 hours. Set times to go to the bathroom to help re-train your bladder.
• Make time for a bathroom stop before leaving the house, getting in the car, or going to bed, even if you don’t feel like you need it.
• Limit how much caffeine, alcohol, carbonated drinks, and spicy foods you take in. These can irritate the bladder, leading to UI.
• Try not to drink large amounts of fluids before going somewhere if you will not have easy access to a bathroom. 
• Do Kegel exercises to strengthen the muscles of the pelvic floor (the area located between your hip bones).
  • This can be done by tightening as if you were trying to stop the flow of urine and 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 do this exercise anywhere, only you will know you’re doing it. You may not feel your bladder control improve for 3 to 6 weeks, so be patient.
• Protect your pelvic muscles by tightening them before a strain, such as sneezing, lifting, or coughing.
• Biofeedback (a mind-body technique used to help control different body functions) 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 working with a physical therapist.
• 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 surgery 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 things you can do to help with this condition.