Why do Prostate Issues cause Incontinence in Men?

The Link between Bladder and Prostate Problems

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Unfortunately, prostate issues are very common among men, and the number of those affected increase with each year. Along with prostate issues often comes Urinary Incontinence; just another unfortunate symptom in an already devastating prostate condition. To better understand why men with prostate issues experience bladder problems, we need to understand the anatomy of the male body.

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What is the Prostate? What does it Do?

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The prostate is a walnut sized gland, that is beneath the bladder and directly in front of the rectum. It is one of the most important parts of the male reproductive system. The prostate gland produces many of the necessary fluids (prostatic fluid) that create sperm, and is secreted at at the time of ejaculation. The urethra, the thin tube that runs from the bladder through the penis to carry urine and sperm, also runs through the prostate. So because the prostate surrounds the urethra (and produces fluids), any direct issues with the prostate can affect urine flow.

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What is Enlarged Prostate (Benign Hyperplasia)? Who does it affect?

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The first common prostate issue that can cause Urinary Incontinence, is an enlarged prostate or benign prostatic hyperplasia (BPH). Prostate enlargement happens to almost all men as they get older. Prostate enlargement rarely occurs before men turn 40 years old, but more than 50% of men in their 60’s, and up to 90% of men in their 70’s and 80’s, have some enlargement. BPH is not cancer, and it does not raise your risk for prostate cancer. Which brings me to the second  prostate issue that may cause bladder issues.

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What is Prostate Cancer? Who does it affect?

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Prostate cancer also enlarges the prostate, due to a growing cancerous tumor within the prostate. According to the Prostate Cancer Foundation, “Prostate cancer is the most common non-skin cancer in America, affecting 1 in 7 men. In 2015, approximately 220,800 men will be diagnosed with prostate cancer.” The average age of men diagnosed are 65 or older, and it is rage before age 40. The majority of men are diagnosed at age 66. Apparently the risk of prostate cancer in younger men has increased nearly 6-fold in the past 20 years.

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Why do Prostate Issues cause Urinary Incontinence?

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Because the prostate surrounds the urethra, nears the bladder, and produces fluids, an enlarged prostate can significantly affect the flow of the urinary stream. When the prostate enlarges, it puts pressure on the bladder and squeezes the urethra. This squeezing pressure can cause a variety of different symptoms.

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Symptoms

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Bladder issues differ, depending on each individual case. Though the symptoms vary, the most common issues experienced while urinating include:

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• Issues starting or stopping urination. Hesitation and or interruption during urination.

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• A slow, weak stream

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• Urge Incontinence – the sudden urge to urinate, even if your bladder is void of all urine (most common symptom)

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• Overflow Incontinence – the inability to completely void the bladder of urine, so large amounts of urine are released at once as the urine builds in the bladder.

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• Stress Incontinence – involuntary leakage when you laugh, sneeze, or swing a golf club (second most common symptom)

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• Urinary Retention – the inability to urinate.

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• Straining to urinate

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• Involuntary leaking and or dribbling

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• Frequent urination

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• Frequent nightly urination (going to the bathroom more than twice a night) or adult bedwetting

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• Pain that comes with blood in urine, and discolored urine.

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Can Prostate Cancer and BPH Treatments Cause Urinary Incontinence?

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The short answer: Yes.

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Although it is not always a side affect.

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Prostate surgery, prostatectomy, is generally used to treat prostate cancer or an enlarged prostate (benign prostatic hyperplasia). Sometimes prostate surgery is used to treat recurring prostate bleeding and urinary problems, but its less typical.

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The process of a prostatectomy consists of the surgeon making an incision in the abdomen, from the length of the belly button to the pubic bone. From there, the prostate, or parts of the prostate, are then removed. If you have cancer in your prostate, the lymph nodes surrounding the prostate gland may also have to be removed. If surrounding nerves are also affected, they too may need to be removed. Depending on how much of the prostate area is removed, you may develop Erectile Dysfunction and Urinary Incontinence.

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A radical prostatectomy is the surgical removal of the entire prostate gland (one treatment for prostate cancer). This removal of the entire prostate makes you at higher risk of acquiring Urinary Incontinence and erectile issues.

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External beam radiation is a cancer or tumor therapy treatment that  uses a high-energy x-ray machine (a linear accelerator), to direct radiation to the tumor. The procedure lasts a few minutes, and is typically repeated several times a week over several months. This treatment may also result in temporary or permanent Urinary Incontinence.

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What is the General Overall Outcome?

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In any case, Urinary Incontinence due to prostate issues is not always permanent. Many men find their bladder leakage dissipates after treatment. Even if the treatments cause bladder problems or they continue, it’s common for symptoms to reduce and disappear over time. The amount of time it takes to recover from the symptoms can range from a couple months to a couple years. Those who experience Urinary Incontinence after treatment do several things to regain control of their bladder in that time.

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• Exercise is a great way to reduce pressure on the bladder, and boost metabolic health to strengthen the body. Specific forms of exercise like Yoga (generally recommended to women with incontinence, but works for men as well), are especially effective.

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• Kegels and other pelvic floor exercises improve symptoms significantly.

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• Changes in diet like avoiding certain trigger foods, or eating foods that battle incontinence, reduce urine leakage.

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• Wearing incontinence supplies maintain a healthy body, by absorbing any bacteria, and toxins in bacteria. The consistent exposure to moisture can also cause infection and rash. Men then wear incontinence supplies or place absorbent materials on beds, and chairs to prevent complications. Many men with urinary incontinence prefer absorbent boxers, liner guards, and adult briefs because they are discreet and fit the male form. While you are treating your urinary incontinence with the methods mentioned above, wearing incontinence supplies will enable you to be active without worry of leakage.

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After the BPH or cancer has been removed and treated, your doctor may recommend other treatments for Urinary Incontinence.

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Ultimately…

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Ultimately men with urinary incontinence due to prostate issues should feel no shame. Surviving such a a surgery and maintaining a normal lifestyle is a challenge and success to be proud of. Prostate issues that commonly cause bladder leakage can happen to any man at any age. Own your incontinence and take control over your life through treatment and healthy behavioral changes. Start off the New Year on a positive note, you’re a brave man.