Urinary Incontinence Among Men More Common Than Thought

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April 4, 2000 (Cleveland) -- Urinary incontinence among men is more common than previously thought, according to a new study, and most men appear to be suffering in silence, possibly because their physicians never ask about incontinence.

About a third of the men in the study "said they had some leakage problems, usually what would be considered mild incontinence," says researcher Steven H. Smoger, MD. Mild incontinence, he says, usually means leakage of "a few drops." Smoger is an associate professor of medicine at the University of Louisville in Kentucky.

Although a large number of men had urinary problems, less than a third of these men talked to their doctor about their condition. But 75% of the incontinent men said they would welcome medical evaluation and treatment, according to the study results published in the April 4 issue of the journal Annals of Internal Medicine.

Smoger tells WebMD that the study of 840 men suggests that although urinary incontinence is common, patients and doctors are taking a don't ask, don't tell approach. Among the men surveyed, almost 15% said they were incontinent at least once a week. Previous prostate and bladder surgery as well as diuretics, or "water pills," were found to increase the rate of incontinence.

Although most of the men had mild incontinence, those who reported severe incontinence, "cases where the men had soaked through their clothes," said the condition had a significant adverse effect on their quality of life. Severe incontinence was seen to worsen emotional health and social relationships, according to the researchers.

Smoger says that urinary incontinence not due to surgery is most common among older men, usually over the age of 60. In these men, the most common type of incontinence is due to overactivity of the bladder, leading to incontinence and more sense of urgency to urinate. There are several medications that can treat this problem, with some of the newer drugs not having as many side effects. Bladder training can also decrease the severity of the problem.

Men with enlarged prostates also can have incontinence, due to the bladder filling up with urine and leaking out. There are medications for this as well that can shrink the prostate and decrease the incontinence.

Men must also be aware that some medications, including Benadryl (diphenhydramine), can cause incontinence. "In this case, stopping the drug can stop the problem," says Smoger. Although some incontinence can be cured with simple approaches such as stopping a drug, Smoger says that in many cases a referral to a urinary specialist is recommended.

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