Leaking urine when you cough, sneeze, laugh, or lift something heavy is frustrating and embarrassing. For some men, urinary leakage becomes a daily concern that affects their confidence, physical activities, and willingness to leave home.
Male stress urinary incontinence occurs when the muscles responsible for keeping urine in the bladder can't maintain adequate control during activities that increase abdominal pressure.
It's common after prostate surgery, although other conditions and procedures can also contribute.
At his practices in Philadelphia, Pennsylvania, Paul Chung, MD, FACS, and our team provide specialized care for men experiencing stress urinary incontinence. Understanding your treatment options can help you determine the best approach to managing persistent leakage.
Pelvic floor exercises, commonly called Kegel exercises, strengthen the muscles that help control urination.
These exercises are often recommended as an initial treatment, particularly for men experiencing incontinence after prostate surgery. Strengthening the pelvic floor may improve bladder control and reduce leakage.
However, performing the exercises correctly is important. A pelvic floor physical therapist can help you identify the appropriate muscles and develop an effective routine.
Although exercises can help some men regain control, they may not provide enough improvement for those with more significant incontinence.
For men with mild to moderate stress urinary incontinence, a urethral sling may provide additional support.
During this procedure, Dr. Chung places a specialized mesh sling beneath the urethra — the tube that carries urine out of your bladder. The sling repositions and supports the urethra to help prevent leakage during physical activity.
One advantage of a male sling is that it works without requiring you to operate a device.
However, slings aren't appropriate for everyone. Men with severe incontinence or a history of pelvic radiation may benefit more from another surgical approach.
An artificial urinary sphincter (AUS) is another surgical option, particularly for men with moderate to severe urinary leakage.
The device consists of three components:
The cuff normally remains closed to prevent urine from leaking. When you need to urinate, you squeeze the pump to temporarily release pressure around the urethra and allow urine to flow.
The American Urological Association recommends discussing artificial urinary sphincters with men experiencing stress urinary incontinence after prostate treatment.
Although the device can significantly reduce leakage, it requires the ability to operate the pump and may eventually need surgical revision or replacement.
Not every treatment works equally well for every man. Before recommending an approach, Dr. Chung evaluates several factors, including:
Your treatment goals and preferences also matter. Some men want to reduce occasional leakage during activities, while others need a solution for significant incontinence.
An individualized evaluation helps determine which option offers the most appropriate balance of potential benefits and risks.
Living with stress urinary incontinence can affect far more than your bathroom habits. Persistent leakage can interfere with activities you enjoy and make everyday situations unnecessarily stressful.
Fortunately, treatment options are available even when exercises or other conservative approaches haven't provided enough improvement.
If you're struggling with urinary leakage, call Dr. Chung's Philadelphia office to schedule an evaluation. Dr. Chung can help you understand your options and determine which treatment may provide better bladder control and improve your quality of life.
