When it comes to how well a man deals with urinary incontinence (UI), there are multiple factors at play that can exacerbate the physical and mental limitations they may feel. The most common is avoidance, which can lead to feelings of isolation. Additionally, many struggle to keep up the appearance of vitality and invincibility while at the same time fearing their vulnerability will be discovered.
Many men will avoid the doctor even when they are feeling fit and healthy. Add a dash of embarrassment or fear to the mix and the result can be silently coping with a condition for which there are many treatments, therapies, and options.
A study out of the Cleveland Clinic’s “MENtion it” campaign showed a staggering 72% of men would rather be doing household chores such as cleaning toilets, than going to the doctor. The study cites reasons such as “superhero syndrome,” which, simply put, is men wanting to appear strong and invincible. Showing vulnerability can be frightening in a culture where a man’s strength is perceived as everything.
When it comes to urinary incontinence, the impact can be even more profound, as some men relate a loss of bladder control as being more disturbing to them than experiencing erectile dysfunction.
Studies show a higher number of women experience incontinence as they age, however, with male urinary incontinence a great many cases go unreported and left untreated. The first step is shattering the stigma that all people who experience incontinence feel, so they can get the help they need to live their best lives.
About Urinary Incontinence in Men
What is Urinary Incontinence in Men?
Urinary incontinence is a loss of bladder control. It is still estimated that 1 in 5 senior adults in Canada is affected by urinary incontinence. Men’s urinary incontinence is not a disease, but rather a symptom of a problem with a man’s urinary tract.
What Causes Urinary Incontinence in Men?
There are 3 basic types of urinary incontinence men are affected by:
Stress urinary incontinence (SUI) is often caused when the prostate is removed (prostatectomy) most often the result of Prostate Cancer. With SUI, leaks most often happen when you cough, lift, or strain.
Urge incontinence is the result of overactive bladder muscles that squeeze so hard the sphincter can’t hold back. With urge incontinence, the urge is so strong, sometimes you just can’t reach the toilet quickly enough.
Overflow incontinence is caused by a blockage in the urethra (such as enlarged prostate) and this leads to urine building up over time. With overflow incontinence, a person can often only release a little urine at a time, they just can’t control the dribble.
Contino is most often helpful for those with SUI (stress urinary incontinence) as a result of prostatectomy.
Mental Health and Urinary Incontinence (UI) in Men
Studies show urinary incontinence doesn’t just affect physical health but it can also have a strong impact on an individual’s mental health. We know men cope with mental health issues differently from women. Women are more likely to reach out to their peers for support, whereas many men will avoid talking about their mental health even to their own detriment.
There are many societal attitudes this behaviour can be attributed to. The pressure to conform to the illusion of invulnerability is one reason. So while the effects of mental health issues in men are felt at nearly the same values as for women (A StatsCan Canadian Community Health Survey on Mental health and well-being found that 10% of men experienced symptoms of the surveyed mental health disorders and substance dependencies, compared to 11% of women), we know most women feel more at ease getting the help they need than men.
The deeply personal nature of men’s urinary incontinence reveals a level of vulnerability many men are so uncomfortable with they simply refuse to talk about it.
The Connection Between Urinary Incontinence and Loneliness in Seniors
Another telling study was performed by StatsCan in 2008/2009. It measured urinary incontinence and reduced quality of life in Canadian seniors. The findings were that UI can have a negative impact on physical, social, and emotional well-being.
People with UI may be less likely to engage in activities outside the home. They may also be susceptible to pressure sores, rashes, and urinary tract infections.
- In 2008/09 more than half a million Canadian seniors reported UI with 9% of men reporting experiencing UI.
- UI is more common among older seniors (age 85 or older) with 19% of men reporting having experienced UI.
- An estimated 1.4 million seniors reported feelings of loneliness (25% of men and 40% of women) with significantly higher numbers of seniors experiencing UI with 34% of men and 53% of women.
The Impact of Living with Incontinence
While the mental health impact of men with UI is enough to warrant exploring ways to manage it so men can regain their freedom and enjoy the things they used to, there are other aspects that also need to be considered.
For some, urinary incontinence is a fact of life, and it’s easier to make a joke or pass off an embarrassing leak or odour as a ‘fact of life’. But the truth is, not every person can do that easily. The worry and fear of embarrassment can take a toll and lead to a person avoiding social situations.
Playing sports, laughing or working hard can trigger leaks, and this has many men avoiding their favourite pastimes or activities to prevent being discovered. This can lead to mounting frustration at still being physically able to play that game of tennis or golf, but not wanting to have an embarrassing leak.
Lack of privacy, dignity
For caregivers, spouses and partners, it’s easy to tell someone experiencing urinary incontinence their condition ‘doesn’t matter’ but the truth is, it does to the one experiencing it. Being able to maintain your dignity is a right everyone should be afforded.
Living with uncertainty
Feeling unsure about your body’s ability to manage leaks can lead to avoiding situations or having to be prepared for emergency clothing or pad changes. Freedom is going out for the day without having to pack extra protection.
Skin irritation and infections
There’s no doubt about it, rashes and infections can hurt. When the skin is frequently moist for long periods of time, it can become prone to irritation. Barrier creams can help but nothing beats feeling dry.
Disposable pads and other solutions can be a costly burden on seniors and their families, and there’s an impact on the environment as well. While it seems negligible, these costs add up over time, and with a seniors’ fixed income this can be a real concern.
The Options for Men Dealing with Urinary Incontinence
While urinary incontinence may be associated with mental health challenges and avoiding the activities you enjoy, it need not stay that way. There are numerous things you can do to minimize the impact on your life.
Particularly if you are recovering from prostate cancer or a prostatectomy, there is great value in reaching out to those who have been there for support. Whether it is to share stories, offer guidance or to just listen, having friends with a shared experience can help you regain your confidence and joie de vivre. Find Cancer support groups
Pads and Absorbent Clothing
When kept dry and clean pads can be an effective and comfortable means of managing urinary incontinence. Challenges arise from needing to perform pad changes while enjoying your favourite activities. These solutions can also cause rashes if a wet pad is not changed frequently.
Collection, compression or pharmaceutical options
There are a wide variety of options available, from catheters (which collect urine and store in a bag which is emptied at intervals) to compression devices (which work by compressing the urethra to prevent leaks) and pharmaceutical options such as relaxants to ease the symptoms of overactive bladder.
Each of these options is recommended for the different causes of urinary incontinence and each has benefits and side effects which can be discussed with your doctor. Avoiding irritation and maintaining your comfort and confidence is key.
Urethral inserts offer an alternative to surgery for stress urinary incontinence. With a urethral insert, a plug is inserted into the urethra that prevents the flow of urine. The urethral insert is simply removed to evacuate the bladder, washed and reused. Studies have shown a dramatic reduction in leaks and the need for pads. With a urethral insert, many men can resume the activities they enjoyed prior to experiencing stress urinary incontinence, such as travel, sports, and social gatherings.
Explore surgical options
In some instances, your doctor can recommend surgical procedures to help you regain control. The Canadian Continence Foundation outlines the various surgical procedures that have been shown to help. Your doctor can advise you if you are a good candidate for a surgical procedure. Visit The Canadian Continence Foundation Men’s Room
Other Ways to Cope with Urinary Incontinence in Men:
- Cut back on caffeine and alcohol
- Stay active
- Maintain a healthy body weight
- Follow the latest information from The Canadian Continence Foundation
- Avoid irritant foods such as citrus fruits, tomato, etc.
- Drink in intervals of 2-3 hours and avoid drinking 2 hrs before bed
- Avoid straining either by trying to urinate or trying to hold urine
- Wear loose-fitting clothing that is easy to remove and less likely to show a leak
- Eat and drink on a regular schedule
How the Contino® Urethral Insert Can Help
Contino® offers promising results in addressing persistent urinary stress incontinence using a urethral insert. The Contino® insert essentially plugs the urethra and is easily removed when it is time to evacuate the bladder.
In 2018, Life 360 Innovations Inc. completed its 5 year multi-site Candian clinical study of Contino. The study demonstrated product safety and significant results.
Study participants experienced a mean reduction in absorbent pad weight of 75% while using Contino®, as well as an improvement in scores measuring the frequency, severity and impact of urinary incontinence (UI) on quality of life. Some participants also observed health improvements related to both urinary function and general health, including improved urge reflex, improved bladder sensitivity, and improved continence. Adverse events related to Contino® were few, minor, and manageable.
Through this study, Contino® was shown as a viable solution for patients with stress urinary incontinence, particularly those with co-morbidities that preclude them from surgery or for those who are unwilling to undergo invasive therapies. Previously, non-surgical remedies included compression devices, collection devices, and pads. These solutions come with a variety of drawbacks, including skin irritation, discomfort, leaks, and inconvenience. With the Contino® urethral plug, test subjects saw a reduction in mean pad weight when using Contino® compared to only pads. The device resulted in a reduction in urine loss and improved patient perception with urinary incontinence.
Contino® is currently available through physiotherapists specializing in men’s pelvic health in Toronto and BC. To see a list of clinics offering Contino® assessments and fittings, visit our Contino® Authorised Clinics page.