Urinary incontinence in men

Incontinence (leakage of urine) is not just a women’s problem. Plenty of men have difficulty controlling their urine.

5% of men under 45 years of age have urinary incontinence.
10–20% of men over 75 years of age have urinary incontinence.

After the age of 65, stress incontinence decreases, while urgency and mixed urinary incontinence increases.

Types of urinary incontinence in men

In men, incontinence can take various forms.

If you have the commonest form, you have to rush to the toilet (urgency), and perhaps leak on the way (urgency incontinence). This is often worse in cold weather or if you hear the sound of running water. You may notice some dribbling after you have passed urine. These problems are most common in older men. They are often partly related to a blockage at the outlet of the bladder, caused by enlargement of the prostate gland – a condition called benign prostatic hyperplasia (BPH).
Some men have had bladder problems all their lives, such as bedwetting, urgency, urgency incontinence or having to pass urine frequently.
Difficulty in holding urine sometimes results from a previous prostate operation, especially if you leak urine with a cough or sneeze, during exercise or standing (stress incontinence). This is common straight after the operation, but often improves within weeks. It can also occur in men who have not had a prostate operation, particularly in older men, but this is uncommon.

Why prostate enlargement causes incontinence

Enlargement of the prostate gland tends to occur with ageing. At 60 years of age, about 40% of men have enlarged prostates, but this rises to 75% by the age of 80. The reason is not known, but it is not a cancerous condition.

A normal adult prostate is about the size of a chestnut and weighs 20–25 g, but it can increase to 60 g or more (a condition called BPH). As it expands, the prostate wraps itself round the neck of the bladder like a collar, restricting the outlet, and the bladder muscle has to work harder to push the urine out.

Because of the obstruction, you notice that you have a poor stream or that starting the stream is difficult or that urine seems to flow in stops and starts.
The strain makes the bladder muscle want to empty more often so that it often starts to contract before the bladder is full, causing urgency. Because the bladder tends to contract before it is full, you will pass urine frequently in small amounts and often have to get up in the night to urinate.
The bladder has difficulty in emptying completely, because the outlet is restricted (like kinking a garden hose), and there is always some urine left inside. Gradually, more and more urine is left inside and, in severe cases, eventually overflows without any feeling of urgency. This is called overflow incontinence.

What you can do

Try to figure out if your prostate is enlarged. If you can answer yes to any of the following questions, it is quite likely that you have an enlarged prostate.

Do you have difficulty in starting to pass urine?
Do you think it takes you too long to pass urine?
Do you pass urine in stops and starts?
Do you dribble urine without full control when you have tried to stop?
Do you have a sensation of not having emptied your bladder completely?
Do you have to get up more than twice a night to pass urine, but only pass small amounts?

If you do think that your prostate may be enlarged, then you should arrange to see your doctor to check that this is the cause of your symptoms.

Decide whether urgency is your main symptom. If you have urgency, you could try ‘bladder retraining’. Some men find this helps, but generally it is not as effective in men as in women. Discuss the problem with your doctor, because there are various medicines that are very effective in calming an overactive bladder.

Dribbling after passing urine. If you dribble after passing urine, try running your finger along the underside of your penis to force out any remaining liquid.

Bed-wetting. If you have always had bladder problems, including wetting the bed at night as an adult, look at the section on bed-wetting and then discuss it with your doctor.

What your doctor can do

Prostate problems. If you think you have an enlarged prostate and the problem is really troubling you, your doctor may decide to try medication. A drug (finasteride) is available to shrink the prostate, but when you stop taking it the prostate starts to grow again. Other drugs (alpha-blockers) relax the bladder neck and the prostate itself, but have side effects in some people. You may need a prostate operation to remove the enlarged prostate.

After a prostate operation. Tell your doctor about your incontinence if it has not improved within a few weeks after a prostate operation. Pelvic floor muscle exercises often help, especially if a pelvic floor specialist (physiotherapist or nurse) shows you how to do them properly. Various operations might be possible, such as insertion of a sling to support the urethra (tube from the bladder), or an implanted device to replace the inadequate neck of the bladder (artificial urinary sphincter).

Other surgery. Men with stress incontinence may be candidates for insertion of an artificial urinary sphincter (AUS). This is a surgically implanted device that involves placing a water-filled cuff around the urethra that is connected to an internal scrotal pump and reservoir near the bladder. Once a patient is ready to urinate, the pump is pressed and water is released from the cuff to the reservoir allowing the flow of urine. After several minutes the water is automatically transferred back into the cuff causing the urethra to close and preventing incontinence. A decrease in the amount of urine leakage is 80 to 80% but complications such as mechanical device failure and need for replacement at ten years is about 30–45% (BJU International 2011;107(Suppl 3):7-10).

Written by: Diane Newman
Edited by: Diane Newman
Last updated: Friday, February 15th 2013

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Comments on this article

Posted by nigel on 12/05/2013 at 09:00

I seem to have a condition known as post micturition dribble, worth checking out, and my wife helped out by getting me to try her pads which work really well no more embarrassing wet patches on the front of my trousers and they are a lot cheaper than male pads.

Posted by Optional on 14/02/2013 at 08:24

im bipoler could that make a diffence

Posted by Optional John on 04/02/2013 at 05:34

I was in a MVA & had MAJOR head trama with brains & brain stems damage, I'm paralyzed on my left sidebar & haveta wear diapers can't tell when I need to go "pee" normally don't gotta issue with poop, but there's been a couple accidents in my sleep & the bad part of myspace accidents is I nevertheless know I have em till after I have them, is this normal?

Posted by Optional on 28/01/2013 at 07:05

i read every thing not only in this syte but others and write short note about problem-1.no control of urine 2.stop and start urinate 3.cold weather is more dangerous 3.at night i go to toilet 4.while touch the water ,a need to urinate 5.a little amount of urine 5.it is not fully empty 6.it occurs again and again 7.sometime bed wetting problem so i think that my problem is enlargement of prostate gland

Posted by mark on 23/01/2013 at 08:50

About 2 years ago I had Radiation treatment for cancer where they put radiation pellets in the prostate gland, eventually that settled down, but left me with with a bladder problem and errectile disfunction After that ,it was decided that I should have treatment to my bladder where they injected some treatment. Still no improvement, Can you suggest anything

Posted by Jason on 21/01/2013 at 08:46

I started to leak urine over 2 years ago and basically can't usually get to the toilet in time. Pretty much the minute I feel the need to go it comes out within seconds. I wear plastic underpants and pads continuously and really hate them - the way they look, the sweatiness and the smell, but I tried other products without success. I just feel really depressed about it and always feel dirty because of the soggy pads and sweaty pants, and having to wear them all the time is awful. I wish there was a product that was more comfortable i.e. breathable and more like normal underpants, but nothing I have seen or tried is absorbent enough or leak proof for me and I don't want nappy style products.

Posted by Optional on 19/01/2013 at 08:00

I leak small amounts of urine all the time - coughing, sneezing, sitting down and getting up,when I'm at the gym lifting weights etc, and also I can't always get to the toilet in time when I really need to go, so when this happens I lose a lot of urine in one go. I have had the problem for over two years and I wear plastic underpants with pads 24/7. I am scared to see a doctor but I know I need to. I am just so embarassed by the problem and wearing plastic pants is awful, they are severely uncomfortable,sore, sweaty, smelly etc especially as I literally can't take them off because I have to have protection in place continuously. I feel very low self esteem as a result but try to get on with things, I just can't face a doctor so I could do with advice on what my condition might be and what I can do to improve it. And any advice on products would be great as getting out of plastic underpants would make such a difference to my life, but it would have to be a totally leakproof product.I tried stretch pants once but I leaked from the edge of my pad. I also use aon incontinence clamp when I go swimming but it has to be so tight to stop my level of leakage that I can only endure it for short periods. thanks

Posted by dad360 on 17/10/2012 at 10:31

Chuck regarding the guards /pads i use during the day use the medical net pants they keep guards/pads securly in place one i use are molimed u can buy from ebay

Posted by Chuck on 22/09/2012 at 04:32

I leak some and a lot more at night / I either wear guards or a diaper at night/ very uncomfortable / I use guards sometimes during the day but im worried they will fall out or be noticed/ women's pads r less noticeable but don't protect as well/ and both require tight underwear that r uncomfortable too

Posted by James on 17/09/2012 at 12:33

I am male and Incontinat, Having seemingly givin up wearing nappies/diapers since I was 2 years old. Iam now having problems & had to start wearing nappies/diapers again it's been a nightmare as They are soo expensive & difficlt to conceal under my cloths. Although I do find that now I am over the problem deriving from embarrisment I now am okay to wear them again, As they provide some advantiges sutch as they are Comfitable,They provide: protection during the day-night. obviously after using them I chance myself and put a clean one on I find Tena Slip Maxi a good choice but then again they are costly although for 3 weeks now I have been using Boots stay dry slips as they are more absorbant and less costly the only downside is they only come in packsof 10 compaired to 24 nappies with the tena product. I have been for a medical scan they found nothing wrong with me although I still have the problem. Any sugestions?

Posted by Sibusiso Joseph Mabuza on 01/09/2012 at 07:27

I might be drinking 1 to 1,8 litres of water a day, so my problem is that I used to pass water so often and I pass them in large amounts! And, I believe it's not normal.

Posted by James on 14/07/2012 at 02:13

Firstly I would Like to state that I am not an adult baby, or have any kind of alternative agenda or reason I wear nappies/Diapers as I was like most people toilet trained as a baby/infant along ago and I will not welcome or respond to any kind of unkind or malicious statements/ snap judgments people may post as to my state of mind so please be considerate and think before you write. I have had problems with urinal incontinence since I turned 13 years old. I strongly think this could be the result of an operation I had to remove some four skin although I can't be 100% sure that was the cause. I first noticed the problem a couple of weeks after the operation whilst I was still recovering although, at first it was a minor problem now it's a major one. & I am finding I now having to wear adult Nappies/Diapers all day & night. Ironic that it has come full-circle and I am back at square one after all these years having not having to wear nappies. At first for years I did not want to share or discuss my problem with anyone as it was too embarrassing for me. I tried to deal with this problem myself only to become a pariah with my parents, who did not understand why I was wearing nappies. They thought until recently when I told them about it, that I had a fetish or Infant sum or similar mental problems. In the past I had made homemade nappies out of tissues or old cotton long sleeved shirts this was because I could not afford to buy the real thing at that time. I just bought some nappies/diapers from my local chemists they where expensive now it seems I could probably get them for free on the NHS as specially as I have 2 trump cards in my favor one being I am on disability living allowance and the second being I am currently on job seekers allowance. And as I am going to hospital next week anyway for a general check up I will make an appointment to see the DR's until then I will continue to wear my Tena Stretch maxi nappies/diapers. Which are proving to be a real asset as I don't have to go to the toilet as often as I use to as-specially at work where I volunteer 3 times a week. This as has had a positive side effect. As it has resulted in increased productivity from myself. So maybe wearing a nappy or diaper can be a good thing after all, Although I find that since I have a lot of urinal incontinence so I have to wear more then 1 at one time usually 4 at one time which I wear discreetly so not to alert un-wanted attention to myself from unsympathetic people, who would only laugh or poke fun at me if I came into work warring noting but my nappies and a T-shirt, in true baby style like in the comedy movie Sean stop or my mom will shoot, As this would be a nightmare of a situation for me as it's not my style. If the doctor says however that I have to wear nappies/diapers 4 the rest of my days I will accept his/her say rather then have to go through with medication or worse another painful operation to resolve this problem. Although any kind of kind and considerate advice on how to affectively deal with this problem would be welcome. As this is the 1st time since I was a baby that I have had to wear nappies/diapers all day & night, and I feels weird to me as I am not use to the fact I may have to back track in life and wear them for the rest of my days. Lastly may I Thank you for your kind comments or advice James.

Posted by Caregiver to 92 y/o on 10/06/2012 at 06:41

My dad is blind,feeble, barely walks to bathroom, enlarged prostate, urine stream stops & starts, dribbles, goes all the time, some retention; able to use bedside urinal, but, constantly holding it. Now trying condom caths: "Liberty" was great (stayed on over 24 hours), but dad can't remove or replace it. I was gone when it leaked & he had no way to use the urinal because Liberty was still on. It has to be removed & replaced immediately...fine if the wearer is able...dad is not; heck, it's difficult for one with nimble fingers to detach it. So now trying Gee Wiz...1st one fell off...second one has remained on for over 24 hours without leaks. It's much easier to apply, and if it falls off, dad can still use the urinal.

Posted by Barbara on 22/12/2011 at 03:07

I noticed an absence of any mention of Male Urinary Incontinence Clamps for Men. The Dribblestop Clamp (manufactured and distributed from Canada) is selling all over the world. If you are not too happy with using drugs, or pads to control incontinence, and do not want the surgery, then perhaps you should consider the Dribblestop Clamp. Just wanted to keep you updated. Thanks

Posted by Bernardo on 03/10/2011 at 06:42

Recently I am dribling, without my knowledge. and sometimes I am not sure if I am going to ejaculate or urine is coming. Could somebody can tell me what is going on?

Posted by Optional John on 26/07/2011 at 04:53

I have had bladder problems for over 12 years and after going for tests end up with a new tablet to take. These last for about 2 years and then the trouble starts again. I;m now taking solifenacin which worked great, but now I am struggling again.

Posted by Optional on 14/02/2011 at 06:44

I find myself leaking at the strangest times and finally told my wife about it. She didn't seem surprised or troubled and suggested I try one of her pads. I did and they are helpful. She uses the brand called Poise. At first they felt strange and I was self conscious but after a while I got use to them and it is now really no problem. No more wories about the delayed leaking after going or the random urge and leak that used to be so annoying. Hey, things don't always work as well when they get older.

Posted by Optional on 11/01/2011 at 11:19

i want to know the percentage of elderly people that suffering from urinary incontinence

Posted by Optional on 28/11/2010 at 10:02

I had a (rigid) cystoscopy botox operation for urge incontince on Monday 22.11.10. I now have have further problems which are very painful to pass water, it now only comes out in dribbles and I really have to force it out. I feel now that I want to urinate most of the time. Maybe as often as 30 minutes after last void. I now feel very uncomfortable all of the time as my "urge" problem has been made worse by having this procedure. Is this a temporary thing or has something gone wrong with the surgery. G.T Loughton.

Posted by CJ on 15/10/2010 at 03:42

Even though I'm only 30, I found myself having this problem too. Its like no matter I tried to shake the last few drops of urine out, after a about a minute there always seemed to be a pee spot on my pants. Recently I found this company called Murphy Overconfident Underwear that makes underwear that absorbs the extra urine. It looks just like regular underwear, but it prevents the pee spots. You can order on their website www.murphywear.com

Posted by Optional on 10/10/2010 at 08:50

I've had a tough case of incontenence ever since prostate surgery. Can't stand the thought of wearing diapers. Found a product that is now available -- with full reimbursement -- called AFEX. Not sure where all it is available, but the company does have a website... www.arcusmedical.com.

Posted by Ricky on 20/09/2010 at 08:42

About 3 months ago I was diagnosed with non-specific urtritis (NSU), I was given antibiotics to clear this problem. No luck after the first week, so I was prescribed with another week of antibiotics but a stronger dose by my GP. Still no luck, and still suffering from the same symptoms. Nothing seemed to be stopping the dribbling of urine after visiting the bathroom, no ease from the irritating itching, sensitivity or aching pain around the pelvic region. I was then told to see a urologist about the problem... still no luck. The specialist couldnt tell me what I was suffering from, they just told me to "milk it" after urinating for 2 months until the next appointment with them. Its been costing me a lot to get no answers and no progress, now, im desperate for help. The only thing that is giving me any relief is a cream that I have to put at the end of my penis whenever it hurts or/and after urinating. This unknown condition I have has now been effecting my work, personality and my contentment. Ive had tests for any STI's and cancer of any kind, all have come back fine. My urine has been tested many times, to which no problems have been found. If anyone has a solution or an idea to what I have, would very much appreciate to hear it. I'd like to tackle this problem once and for all.. and move on.

Posted by Optional on 18/04/2010 at 06:58

Can chronic prostatitis and bladder infection cause symptoms of urge incontinence in older men (70-80) ?

Posted by Optional on 31/03/2010 at 09:02

If a catheta is fittd is it still possible to urinate naturally when i is felt to be necessary

Posted by GeeWhiz Customer on 17/01/2010 at 05:03

I appreciate this info. What is described as UI problem is what happens to me. I use and external condom catheter called GeeWhiz and started a customer blog that you can read and leave a comment: http://geewhizrelief.blogspot.com/

Posted by Anonymous on 29/03/2009 at 10:05

Dribbling after passing urine - thats me. I even ask my penis "are you done?" and I get a nod, I get a "ok NOW Im done" after a little dribble. Ive tried waiting an extra 5-10 seconds to relax and make sure its all out but once Im zipped up I get a few more drops. Normally its only enough to dampen my boxers in a small small spot, but if I ever hastily hurry myself I pray that I am not wearing light blue jeans because there has been enough drops to make its way to the jeans. Black jeans or take my time has been my solution for my problem.

Posted by Ron on 17/03/2009 at 04:01

My problems are from bph wet the bed and have some accidents during the day.The informationwas very interesting.

Posted by Anonymous on 17/03/2009 at 12:43

I am 18 and I have a problem my pennis leaks small amounts of urine during the day. It gets realy uncomfortably trying to proform every day acitivies I dont have any of the signs of an enlarged prostate, is there anyhing i can do about it.

Posted by Joe Landon on 02/03/2009 at 06:01

I am 43 and I have had this all my life and my Dad said it was pure lazyness And now I have no feeling in my buttom And in Front and penis.

Posted by Anonymous on 28/01/2009 at 01:51

I have problem with Dribbling after passing urine. I haven't tried yet but after reading from this web page i will try. thanks