Both men and women experience incontinence—partial or full loss of bladder control. For women, it could be caused by weakened pelvic floor muscles, most likely from childbirth.
For men, the most common causes of urinary incontinence are benign prostate disease, an overactive bladder or injury to the urethral sphincter resulting from surgical treatment of prostate disorders such as prostate cancer.
Treatments range from nonsurgical options such as exercise, behavioral modification or medications; to minimally invasive microwave or laser treatments; to surgical options such as the placement of a urethral sling, lifting of the pelvic floor, or creation of an artificial urinary sphincter.
Incontinence Treatments for Women
In women, the most common causes of urinary incontinence are an overactive bladder or weakened pelvic floor and sphincter muscles. Nonsurgical treatment can be directed at behavioral modification consisting of fluid intake management, timed voiding, biofeedback, and pelvic floor muscle exercise. Medication for over- active bladder can be taken to help with urinary urgency incontinence or the loss of urine associated with an abrupt desire to void.
Surgical treatment for female urinary incontinence includes:
- Urethral sling surgery
Placement of a synthetic or biological graft under the bladder and urethra to help support the bladder opening to prevent stress urinary incontinence (the loss of urine associated with coughing, laughing, sneezing, lifting, running).
- Pelvic floor/bladder neck suspension
Lifting the vaginal contents such as the bladder, uterus, and rectum. Sometimes using robotic arms through small incisions over the pelvis to place support at the bladder opening to help it close properly.
- Periurethral bulking agent injection
Injecting collagen or some other type of bulking agent next to the urethra/bladder opening to help prevent leakage of urine.
- Sacral nerve stimulation
Placing a tiny electrode next to the nerves for bladder control to help adjust nerve signals to treat urinary frequency, urgency, and excessive nighttime voiding.
Incontinence Treatments for Men
In men, the most common causes of urinary incontinence relate to benign prostate hypertrophy (BPH), overactive bladder, or urethral sphincter injury that can come from surgical treatment of prostate disorders such as prostate cancer. Nonsurgical treatment of BPH and OAB consist of herbal supplements, prescription medication, and behavioral modification such as timed voiding and fluid intake management.
- Minimally invasive therapy (MIT)
Male incontinence related to BPH can be treated with cooled transurethral microwave thermotherapy (TUMT) of the prostate. OAB treatment in men can also include sacral nerve stimulation (see above).
- Surgical treatment
BPH-related incontinence can be treated with GreenLight XPS Laser and GyrusTM TURP. Urethral sphincter damage or injury can be surgically treated with a male urethral sling, which involves placing graft material the area between the scrotum and the anus, to help tighten the urethra. Another option is the creation of an artificial urinary sphincter, an inflatable donut-shaped device placed around the urethra to help it close.