Mr Mo Belal
Consultant Urologist
Male urinary incontinence can be a sensitive and embarrassing issue for patients, but there are numerous ways to manage the condition.
Specialists urge people to have confidence in approaching their GP about incontinence treatment. Mohammed Belal, a consultant urologist at the Queen Elizabeth Hospital in Birmingham, underlines the importance of putting patients in control of their incontinence issues through education and information about support and treatment while working to break down the stigmas associated with the condition.
Urinary incontinence is normal with age
A key element lies in ‘normalising the condition.’ “It’s important to reassure patients that urinary incontinence is a common condition that affects many people — particularly as they age — and that they are not alone and help is available,” Mr Belal says.
Explaining the types of urinary incontinence and their causes is also important, alongside making information available about treatment options and strategies for people to manage their symptoms.
“Keeping a diary to identify patterns in symptoms, such as triggers that lead to leaks, is of value and can also be a basis to enable patients to communicate more effectively with their GP,” he adds.
There are effective treatments available, and he encourages patients to make an appointment with their GP to discuss their concerns. Brochures, videos and websites can help patients learn more about the condition and its management, and they can also get support from healthcare professionals, friends, family members and specialist support groups.
What causes urinary incontinence?
Causes and symptoms of urinary incontinence in men can include overactive bladder syndrome where there is a need to urgently or frequently go to the toilet. “This affects up to 12% of the population over 40 and increases with age,” explains Mr Belal.
In cases of benign enlargement of the prostate gland, the urethra is squeezed, making it difficult to control urine flow. Prostate cancer treatment can also be a cause, either from surgery or radiation therapy as nerves responsible for continence can be damaged.
In addition, neurological disorders such as Parkinson’s disease, multiple sclerosis and spinal cord injuries can interfere with the signals between the bladder and brain, leading to urinary incontinence.
This affects up to 12% of the population over 40 and increases with age.
Behavioural and medicinal treatment options
Treatment options depend on the underlying cause and severity of the condition. Behavioural therapy involves exercises to strengthen the pelvic muscles; bladder re-training techniques to improve bladder control; while medication may be prescribed to relax the bladder muscles, reduce urinary frequency and reduce the size of the prostate gland.
Surgery may be recommended in more serious cases. Another option is electrical stimulation where an implantable device delivers electrical impulses to the sacral nerves to improve bladder and bowel control, such as Medtronic’s InterStim™ system.
“In rare cases, a catheter may be used to manage urinary incontinence,” adds Mr Belal.
A range of absorbent products such as pads, liners and adult nappies are also available to manage incontinence.
Actively breaking the stigma
An important step with male incontinence is to break the stigma associated with it.
“That requires a multifaceted approach which involves educating people about the condition and its causes, raising awareness and providing support to individuals who experience the condition,” he says.
As the common problem affects millions of people worldwide, he also advocates encouraging open conversations about urinary incontinence to normalise the condition.
There are public awareness campaigns and support groups which can provide a safe and supportive environment for individuals with urinary incontinence to share their experiences and receive emotional support.
“Healthcare providers can play a crucial role in facilitating these conversations and providing support to patients,” Mr Belal concludes. “Breaking the stigma associated with urinary incontinence will take time and effort, but with education, awareness and support, we can work towards a more inclusive and accepting society.”
