How Does Prostate Health Impact Incontinence?
A healthy prostate gland is about the size of a walnut and easy to ignore. With increasing age, though, most men will experience prostate enlargement or other related problems, the first signs of which usually include urinary tract symptoms. One of these symptoms can be urinary incontinence -- the accidental leaking or dribbling of urine -- which occurs in up to 15 percent of men over the age of 60 due to prostate disease or other medical causes.
Role of Anatomy
Because of the close proximity of the prostate and urethra, prostate problems commonly lead to urinary symptoms. As your bladder becomes full, it sends out a nerve signal that it’s time to urinate. Muscles in the wall tighten up to help empty the bladder, and a muscular sphincter at the bladder neck relaxes to release urine into the urethra and out to the penis. Your prostate gland lies next to the bladder neck and wraps around the urethra, meaning changes in prostate size and shape can slow down the flow of urine and increase the pressure your bladder has to work against to empty. Difficulty urinating and incomplete bladder emptying often result, in some cases leading to incontinence.
Role of Inflammation
A common inflammatory condition called prostatitis can lead to tenderness and swelling of your prostate. The swollen prostate presses on the urethra, blocking normal flow of urine. Irritation of the bladder muscles and urinary tract infections can also occur. Symptoms include pelvic pain, painful or difficult urination, having to urinate more often or suddenly, and sometimes incontinence. Prostatitis can be caused by a bacterial infection, but more often no clear cause is found and symptoms can last for months.
Role of Enlargement
Benign prostatic hyperplasia, or BPH, is a noncancerous enlargement of the prostate gland, affecting over half of men in their 60s and up to 90 percent over the age of 70. As the prostate enlarges, it squeezes the urethra and can keep the bladder from emptying completely. With time, an overfull bladder becomes stretched and more prone to leaking. Other common symptoms of BPH include difficulty urinating; more frequent need to urinate, especially at night; slow urine flow; still feeling the need to urinate right after doing so; and sudden strong urges to urinate.
Role of Cancer Treatments
Although prostate cancer doesn’t usually cause incontinence, prostate cancer treatments can. Surgical removal of the prostate gland, called radical prostatectomy, also removes part of the urethra, during which damage to the bladder sphincter can occur. Incontinence for a few weeks to several months after surgery is common, but long-term incontinence occurs in fewer than 10 percent of patients. Some radiation treatments can also irritate or damage the bladder, leading to incontinence.
Approaches to Incontinence
If you think you might have urinary symptoms due to a prostate problem, discuss your concerns with your health care provider. Many different treatment options are available, depending on the type of prostate problem you have and the severity of your symptoms. For temporary or mild incontinence, you can use disposable undergarments or absorbent pads. Lifestyle changes, such as drinking less fluid, regularly scheduled trips to the bathroom to avoid bladder overfilling, or special pelvic exercises can help. For more serious incontinence, medications or surgery are available.