Urinary incontinence is the medical term used to describe the condition of not being able to control the flow of urine from your body. It usually happens because the bladder sphincter is damaged or scarred and cannot squeeze or close off the urethra. This means urine can leak or flow freely from the bladder.

In men, the urinary sphincter muscle is located below the prostate and surrounds the urethra. When the sphincter muscle tightens, it holds urine in the bladder. When it relaxes the urethra opens and allows urine to flow outside the body. Incontinence is not a disease in itself, but rather a symptom or result of some underlying condition. To determine the type and cause of incontinence, doctors take a complete medical history and conduct a thorough physical examination. Specialists such as urologists use a variety of testing methods, which may include cystoscopy and urodynamic testing, to determine the cause and type of urinary incontinence.

Types of Urinary Incontinence

There are five basic types of incontinence. In many cases, individuals experience symptoms of more than one type of incontinence. Proper diagnosis of the type of incontinence is an important factor in successful treatment.

• Stress Incontinence-Occurs when you leak urine during a physical activity like lifting, exercising, sneezing and coughing.
  
• Urge Incontinence-Occurs when you have an overwhelming need to urinate and are not able to hold urine long enough to reach a toilet.
  
• Mixed Incontinence-A combination of stress and urge incontinence, where you have symptoms of both conditions.
  
• Overflow Incontinence-When your bladder never completely empties, which causes urine to overflow or leak.
  
• Functional Incontinence-Factors outside the lower urinary tract, such as weaknesses in physical and/or cognitive function.

Causes of Urinary Incontinence

A variety of health-related factors can result in urinary incontinence. To effectively diagnose and treat urinary incontinence, a doctor must determine the cause.

• Removal of the Prostate—Urinary incontinence can occur following prostate surgery. For men, a radical prostatectomy to treat cancer is the most common cause of urinary incontinence. Incontinence is less frequent but may occur following prostate surgery to treat an enlarged prostate (benign prostatic hyperplasia or BPH). When incontinence persists beyond a few months, you should consult your doctor.
  
• Infections and Medications—Urinary tract infections can cause temporary incontinence and certain medications may increase the likelihood of temporary incontinence.
  
• Diseases—Causes of chronic incontinence include diseases or conditions that damage or weaken the urinary sphincter muscle. Spinal cord problems such as spina bifida, spinal cord injury and sacral agenesis (malformation of the lower spine) can cause incontinence, as can neurological diseases such as multiple sclerosis, Parkinson's disease, stroke, and diabetes.
  
• DESD—Incontinence also may be the result of detrusor external sphincter dyssynergia. DESD is a serious condition most frequently seen in patients with spinal cord injury and multiple sclerosis. It is caused by lesions between the brain stem and the lower part (sacral region) of the spinal cord.
  
• Urethral Stricture—This is an area of hardened tissue that narrows the urethra, sometimes making it difficult to urinate. Urethral strictures can occur from scarring, trauma or infections. Strictures most commonly result in urinary incontinence when they involve the urethral sphincter.

Treatment
Men with incontinence can manage urinary leakage by using a number of different options.

Absorbent Products
Absorbent pads, diapers and garments can help individuals deal with bladder control problems.

Internal Collection Devices
An internal collection device, such as a Foley catheter (a hollow plastic tube) can drain urine directly into an external drainage bag. Long term these may be associated with urinary infections and renal failure.

External Devices
External collection devices, such as external condom catheters, are attached to the shaft of the penis by adhesive, latex or foam strap devices, and a tube draining to a urine-collecting bag.

External occluding (closing) devices can be used to block the flow of urine by squeezing the urethra shut or plugging the urethra. Mechanical devices include penile clamps (e.g., the Cunningham clamp) and compression rings. Penile clamps and compression rings can result in penile and urethral erosion, penile edema (swelling), pain and obstruction.

Biofeedback/Electrical Stimulation

Biofeedback/Electrical Stimulation is practiced to help people gain awareness and control of their urinary tract muscles. The principle of biofeedback is simple: instruments are used to record small electrical signals that are given off when specific muscles are squeezed to urinate. This muscle activity is then converted into audio (hearing) and/or visual (hearing) signals that patients can recognize and learn in order to control and coordinate muscular activity.

Surgical Options
Surgical procedures are available to treat male urinary stress incontinence.

• Injections of bulk-producing agents, such as collagen, into the urinary sphincter.
  
• Implanting a male sling, a device designed to support the muscles around the urethra.
  
• Implanting an artificial urinary sphincter, which mimics the function of a normal, healthy urinary sphincter.