Stress Urinary Incontinence in Men with Urologist, Ajaydeep Sidhu, MD
June 17, 2024
Medically Reviewed by Ajaydeep Sidhu, MD
Ever sneezed and simultaneously felt urine dribble from your bladder? People often associate stress urinary incontinence with women since it's a common challenge after pregnancy and childbirth — often reemerging in the elder years. Yet, men can experience this as well.
According to Vitti Nictor, MD, in his published work, "The Prevalence of Urinary Incontinence" within the National Institutes of Health, "Stress incontinence accounts for [just under] 10 percent of cases and is attributable to prostate surgery, trauma or neurological injury." While uncommon, stress urinary incontinence can happen to men.
So, we sat down with WakeMed urologist, Ajaydeep Sidhu, MD, our resident expert on stress urinary incontinence in men, to explore the signs and symptoms as well as treatment options to help men get back on track to sound urinary health.
What is stress urinary incontinence?
Stress urinary incontinence is the involuntary loss of urine associated with maneuvers for activities within the abdomen. Anything that increases abdominal pressure, including the following, can lead to challenges holding urine:
- laughing
- sneezing
- coughing
- standing up
- exercising
- walking
- having sex
It happens almost exclusively after prostate related surgeries, the bulk of which are prostatectomies to remove the prostate for prostate cancer and then to a lesser extent procedures to treat enlarged prostate. Radiation for pelvic cancers can be a risk factor as well.
Is there an age range when a man is more likely to experience stress urinary incontinence?
This is more prevalent in older men, but anybody who's had treatments for enlarged prostate or prostate cancer may be susceptible. Many men who undergo radical prostatectomy will face some level of stress urinary incontinence in the short term. The vast majority of men recover well and don't have ongoing incontinence. Typically, around 12 to 18 months after surgery, about 90 percent of men are dry. About 10 percent of men continue to experience these symptoms and may need to consider additional treatments.
What are treatment options for men to regain bladder control?
- Men should start Kegel exercises or even formal pelvic floor physical therapy — available through WakeMed. It's very helpful for those with mild incontinence.
- For men with a more substantial leakage, options include pads, absorbent materials, external catheters and surgical treatment options.
- I offer surgical options. Careful patient selection is key.
- Urethral bulking is an option, but unfortunately has not been very successful in male post-prostatectomy patients.
- One surgical treatment procedure I offer is a sling that some men who have mild to moderate incontinence can consider if they have not had a history of radiation. During the procedure, a synthetic mesh is strategically positioned around the urethral bulb. The sling compresses the urethra and sphincter, effectively displacing it to a modified and desired location.
- For men who have been radiated or who have moderate to severe incontinence, an artificial urinary sphincter (AUS) is the gold standard surgical treatment option for incontinence in men. An AUS is a device that uses an inflatable cuff to control urine flow. This cuff is positioned around the urethra, the tube that carries urine from the bladder out of the body, near its junction with the bladder. A separate balloon placed in the abdomen regulates the pressure and tightness of the cuff, effectively acting as a valve to control urine release. A simple pump placed in the scrotum allows a man to open the AUS, as needed, to empty the bladder. It is important that patient’s have the dexterity and cognitive ability to manage the device prior to considering implantation.
At what point, should a man move toward surgery to relieve incontinence?
Every man is different. Many shy away from surgery as an initial option, so that's where physical therapy can be a helpful starting point. Ultimately, it is their decision, and I help guide them into what I think is going to be the best option for them given their degree of leakage and their history.
Ultimately, there are many options to treat stress urinary incontinence in men. No man should suffer in silence. A urologist can help.
Want to learn more from Dr. Sidhu on this Men's Health topic?
Don’t let erectile dysfunction (ED) and urinary incontinence stop you from living your best life. Regardless of the cause, your urologist can work with you to ensure you get the treatment you need to help you get back to a lifestyle you enjoy.
Join WakeMed urologist and men’s health expert Ajaydeep Sidhu, MD as he discusses the signs, symptoms and treatment options for erectile dysfunction and urinary incontinence.
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About Ajaydeep Sidhu, MD
Dr. Ajaydeep Sidhu is a urologist with clinical interests in the management of enlarged prostate, urethral reconstruction, complex pelvic reconstruction, erectile dysfunction, Peyronie's disease, male and female incontinence and voiding dysfunction, and pelvic organ prolapse. He joins WakeMed Urology after completing residency at Mount Sinai Medical Center in Miami Beach, FL and fellowship in Pelvic Reconstruction and Voiding Dysfunction from Memorial Sloan Kettering Cancer Center in New York, NY.
He has authored numerous abstracts and articles published in peer-reviewed journals including The Journal of Urology, The Journal of Endourology, Urology, Advances in Urology and The Journal of Sexual Medicine. He believes in treating the whole patient with respect and compassion while upholding a commitment to providing the best care.
In his free time, Dr. Sidhu enjoys spending time with his family, hiking, skiing, golfing (poorly) and finding new restaurants.
About WakeMed Urology
WakeMed Urology offers an outstanding team of urologists and urology surgeons who offer the most advanced urological services at locations throughout Raleigh, North Raleigh, Cary, and Garner, NC.