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Male Incontinence

Definition

Incontinence is the inability to control urination, and/or the passing of faeces. There is a loss of urine from the bladder at inconvenient times. The amount of urine can vary from only a few drops to larger flows. In this topic we will be discussing urinary Incontinence.

Description

Types of Incontinence:

  • Stress Incontinence occurs when the bladder leaks due to coughing, sneezing, laughing or lifting heavy objects.
  • Urge Incontinence occurs when a sudden overwhelming urge causes spontaneous urination.
  • Overflow Incontinence occurs when the bladder is completely full but cannot empty properly.
  • Bladder Incontinence describes Incontinence in the elderly even though it is not an inevitable part of old age.

The pelvic floor muscles are important for urinary control. If these muscles are firm they support the bladder and stop leaks when you cough or sneeze. If they are weak it is difficult to prevent wetting. These muscles, like any others, can be made stronger with exercise.

Cause

Men may have bladder control problems for the following reasons: prostate gland surgery, smoking, heavy lifting, a muscle weakness of the urinary sphincter or pelvic floor, lack of exercise, nervous system disorders, constipation, obesity, certain medications, spinal injury, stroke and nutritional deficiencies.

Signs and Symptoms

Signs and Symptoms include: wetting yourself when you sneeze, cough, jog, laugh, lift something heavy or on the way to the toilet, a heavy dragging feeling in the crotch area and reduced sexual sensation and pleasure.

Warning signs of Incontinence include: leakage of urine regardless of the amount, when you cough, sneeze, laugh or stand, not making it to the toilet and leaking urine on the way, bedwetting (at any age over 6 years), an urgent need to pass urine, being unable to hold on, passing urine more frequently (more than 8 times per day), and only passing small amounts (less than 300 mls), difficulty getting your stream started or a stream that stops and starts instead of flowing smoothly.

Diet Hints

  • Foods high in magnesium may help Incontinence. These include almonds, cashews, green leafy vegetables, figs, whole grains and fish.
  • Foods high in silica are thought to support the bladder. Sources include almonds, peanuts, sunflower seeds, linseeds, lean red meat, strawberries and alfalfa.
  • Herbal teas such as horsetail, valerian, lemon balm and uva ursi may be of assistance. Drink a cup morning and afternoon.
  • Try to reduce caffeine beverages such as coffee, tea and cola.
  • Try to include foods high in B group vitamins to help the nervous system. These include brewer's yeast, nuts, seeds and fresh vegetables.
  • Increase fibre intake to avoid constipation. Psyllium, guar gum, apple pectin, fresh fruit and vegetables are good sources.

Vitamins/Minerals/Herbs

Vitamins may only be of assistance if dietary intake is inadequate.

  • A new herbal preparation in tablet or cream form is available in Australia for bladder control. Ask your pharmacist.
  • Silica is a mineral which is believed to strengthen and maintain elasticity of tissues.
  • Horsetail herb is very high in silica and may help strengthen connective tissues and reduce urinary tract irritation.
  • Calcium Fluoride is thought to increase integrity and strength of tissues. It is also thought to help prolapsed tissue.
  • Magnesium and calcium may support weak muscles and nerves.

Exercises

Exercise programme for pelvic floor muscles.

Identify the area:

  • Sit, stand or lie comfortably, with the muscles of the seat, abdomen and legs relaxed. Pretend you are trying to control diarrhoea by tightening the back passage (anus). Do this several times until you are sure you are exercising the correct area.
  • When passing urine, try to stop the flow mid-stream by tightening the muscles around the outlet (urethra). Then relax and completely empty the bladder. Exercise the muscles:

Exercise the muscles:

  • When sitting or lying down, tighten the anus, then the muscles around the urethra.
  • When you are able to, tighten the areas together. Do this to a count of 3, then release and relax. The exercises need to be repeated often during the day.

To check that you are tightening the bladder correctly, you may stop the flow when passing water. Do this no more often than once a week.

Remember:

  • It takes time to restore muscle strength. You may find that improvement can continue slowly for up to 3 to 6 months. Muscles do not strengthen overnight.
  • This is a brief guide. You are advised to seek help from a physiotherapist interested in Bladder Control problems.
  • Do your pelvic floor exercises daily - you can do them anywhere without anyone noticing - when driving, doing the dishes, watching television or waiting for a bus.

Pharmacist's Advice

Ask your Pharmacist for advice.

  • Your Pharmacist stocks a range of moisture absorbing pads. These have to be fitted correctly.
  • Follow the Pelvic Floor Muscle Exercises suggested in this topic.
  • A new herbal preparation in tablet or cream form is available for bladder control. Ask your Pharmacist for more information.
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