Although the incidence of urinary incontinence among men is lower than among women, it is much more common than is commonly thought. As age increases, the incidence also increases. However, it is not simply a matter of age, it is directly related to other conditions such as prostate enlargement, prostate cancer and neurological disorders such as multiple sclerosis, Parkinson’s disease and Alzheimer’s, and to a lesser extent, diabetes and being overweight.
WHAT IS IT?
It is the involuntary loss of urine. It can be in varying degrees of severity, from a single drop to liters. There are 3 types:
- Stress urination that occurs with exertion.
- Urgency: an involuntary urge to urinate is triggered and urination is performed (there is no time to get to the toilet).
- Mixed: it has parts of both.
Urinary incontinence in men occurs mainly due to prostate or pelvic surgery. It is usually due to stress.
It can occur due to other factors: congenital diseases, trauma, fistulas, neurological diseases and others.
A medical consultation with a specialist in this pathology should be made. This disease is relatively infrequent and difficult to manage, for this reason groups specialized in these pathologies are recommended for its management.
In addition, a physical examination will be performed to assess the condition of the penis, prostate, sphincter indemnity, etc.
Pad test: we measure how much urine is lost daily, the absorbent is weighed before and after putting it on daily.
Cystoscopy: we evaluate the condition of the urethra and bladder by introducing a camera.
Urodynamic study: we evaluate a urination to see how the bladder behaves.
It should begin with pelvic floor rehabilitation.
If urine loss is less than 300 ml, a suburethral sling is implanted. This procedure is performed under sedation. It is usually minimally invasive and the results in expert hands are excellent.
If the loss is greater than 500 ml or there is previous radiotherapy, an artificial urinary sphincter should be implanted.
Artificial urinary sphincter
If the loss is greater than 500 or there is previous radiotherapy, an artificial urinary sphincter should be implanted.
It is a device consisting of a float that is normally inflated, embraces the urethra and thus occludes it, preventing urine leakage. This float is connected to a pump located in the scrotum. When we want to urinate, the pump is activated and thus the urethral cuff=float is emptied and the bladder can be emptied.
The degree of satisfaction is very high, but it is a complex procedure that can have serious complications: urethral perforation, infection, tissue necrosis and others.
Our group is one of the most experienced in this type of intervention.
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