Urinary incontinence consists of spontaneous urine leakage in an involuntary manner.
It is not in itself a disease, but the consequence of other treatments or pathologies.
This pathology is rare in men and, therefore, the Ministry of Health itself recommends that patients are treated in benchmark centres. Our Unit is considered as such within this field.
There are three types of incontinence:
Involuntary urination caused by an increase in abdominal pressure, for example, during coughing, sneezing, while getting up, walking, weightlifting, etc. The reason is usually found in an anatomical alteration of the sphincter system and the pelvic floor.
The main causes of stress urinary incontinence in men are:
- Radical prostatectomy (prostate cancer surgical treatment).
- Surgery for benign prostatic hyperplasia (if the external sphincter is affected).
Involuntary urination secondary to involuntary bladder contraction while the bladder is filling. There is a strong urgency to go to the bathroom, with associated urinary leakage and night-time incontinence.
The main causes of urge urinary incontinence in men are:
- Neurological diseases.
- Radiotherapy in the treatment of prostate cancer.
- Benign prostatic hyperplasia.
It combines both mechanisms. There are other types of involuntary urinary leakage, such as overflow incontinence. It occurs when the bladder is full of urine and the pressure it exerts on the sphincter exceeds its holding capacity. It occurs in patients who, normally due to benign prostatic hyperplasia, retain large amounts of urine chronically, due to their inability to empty the bladder.
To reach diagnosis, it is essential to ask the patient how does it happen, in which situations, which are the triggers, the amount, if they need absorbent pads, if it happens during the night, etc. In this context, it is very useful to use a voiding diary, where the patient writes down the amount of liquid ingested and the number of urination events taking place throughout the day, quantifying the volume of urine evacuated during each of them. This registry must be completed for at least 3 days.
Other tests used during evaluation include: ultrasound of the urinary system, flowmetry and urodynamic testing (which reproduces the functioning of the bladder) and the PAD test, which quantifies the grams of urine leaked (by weighing the absorbent pads before and after use). Urinary tract infections and urethral stenosis (strictures) should also be ruled out.