What Causes Urinary Incontinence in Men?

Medically Reviewed by Minesh Khatri, MD on May 27, 2023
4 min read

If you have a hard time controlling when urine comes out of your body, it’s called urinary incontinence. It means your body has lost some control over your bladder.

It can be frustrating and embarrassing, but figuring out what’s causing your pee to leak can help you find ways to treat and cope with the problem.    

Normally, urine moves from your kidneys to your bladder through tubes called ureters. Your bladder stores your urine until a signal tells your brain that your bladder is full. Then urine leaves your body through a tube in your penis called the urethra. Urinary incontinence happens either because the signal to your brain gets scrambled or doesn’t happen, or because of a problem somewhere in your urinary tract.

You may leak urine because:       

  • Your bladder squeezes too hard or at the wrong time
  • The muscles around your urethra don’t work the way they should
  • Your bladder doesn’t empty when it needs to, and gets too full
  • Something is blocking your urethra
  • Your urinary tract didn’t form correctly     

There are several reasons these things might be happening. There might be a medical condition behind it, or you may have had surgery recently that affects your bladder control.     

There are several health and lifestyle issues that can make you start to leak urine. They can include:

Problems with your prostate. It’s common for prostate issues to cause urinary incontinence. Your prostate may be larger due to a non-cancerous condition called benign prostatic hyperplasia (BPH). Your prostate may also be bigger than usual because of cancer. An enlarged prostate can block your urethra. When your urethra is blocked, your bladder has to work harder to squeeze pee out. This makes its walls thicker and weaker. That makes it hard for your bladder to empty all the urine in it.

You can also struggle with urinary incontinence with prostate cancer or after having certain treatments for it -- such as radiation treatment or surgery to remove your prostate. The surgery may cause problems with the nerves that control your bladder.

Certain diseases. Multiple sclerosis is a disease that can damage the nerves that tell the bladder when to empty and can also lead to bladder spasms. Some other conditions that can damage your nerves and keep your bladder from sending or receiving the signals it needs to work correctly are:

Surgery. Major bowel surgery, lower back surgery, and prostate surgery can all cause problems with your bladder. This is usually because some of the nerves in your urinary tract have been damaged during surgery.

Old age. Just like other muscles in your body, your bladder loses some of its tone and strength as you age and this can cause leaks.

Obesity or lack of exercise. When you don’t get enough activity, you may start carrying extra weight. When you add pounds to your body, your bladder feels more pressure. This can make you go to the bathroom more often, because you have a harder time holding your urine for a long time.

Chronic coughing. If sickness, allergies, or other problems keep you in coughing fits, it can put stress on your bladder and pelvic floor muscles. If they’re weak, they may struggle to keep pee inside.

Urinary tract infection. Bacteria can sometimes infect part of your urinary tract. The infection can irritate your bladder and cause incontinence.

Constipation. When your stool is hard or backed up, it can press on the nerves to your urinary system. This can cause leaks.

Also good to know: drinking alcohol or taking certain medications like diuretics, antidepressants, sedatives, narcotics, or over-the-counter cold and diet medicines can make urinary incontinence worse. So, though they don’t cause the problem, they can worsen your symptoms.     

It’s time to get things checked out if:

  • You have to go to the bathroom a lot more than usual, and often can’t hold in your urine until you get to the toilet
  • You leak when you sneeze, cough, or even stand up
  • You leak at random times, even if you didn’t cough or sneeze
  • You feel like your bladder still has urine in it, even after you go
  • Your stream of urine is weak
  • You have to strain when you urinate
  • It hurts to urinate
  • You feel pressure in your lower abdomen