Male urinary incontinence

The term "incontinence" usually refers to involuntary urination - in particular urinary incontinence in men. This problem can occur at any age, but it is never a separate pathology. Usually it is a consequence of a number of different disease processes in the body. Urinary incontinence is not just a nuisance, but also a decrease in the quality of life, the emergence of difficulties at home and at work, problems in the family, which in general puts a lot of psychological pressure on the patient. What do I need to know about this disorder and how to cope with it? [1]

Epidemiology

In boys under six years of age, physiologic urinary incontinence may be present. However, from about six years of age, the child should already have full control over urinary excretion. If we talk about adults, then one out of two hundred people, at least sometimes have cases of loss of control over urination. In general, incontinence affects about 1% of patients over the age of 18.

Urinary incontinence is less common in older men than in women. [2]

Causes of the male urinary incontinence

Before thinking about the treatment of urinary incontinence, it is first necessary to clarify the cause of the problem, because it is with its elimination and it is necessary to begin treatment measures. So, the main "male" causes are considered such: [3]

• prostate adenoma, other tumor processes;
• previous surgeries that may have affected the work of the genitourinary sphere;
• urethral fistula;
• neurological disorders (impaired cerebral circulation, Alzheimer's or Parkinson's disease, multiple sclerosis);
• head injuries;
• spinal injuries;
• infectious and inflammatory processes of the urinary system;
• prolonged treatment with antidepressants, diuretics, antihistamines, tranquilizers;
• Abuse of alcohol or medications;
• stress conditions, mental disorders;
• developmental defects in the urinary system;
• pelvic organ prolapse;
• urolithiasis;
• age-related weakening of the musculature, enlargement of the urethral lumen.

Risk factors

Factors in the occurrence of urinary incontinence in men include:

• advanced age;
• symptom-complex SNMP;
• Infectious and inflammatory diseases of the urogenital system;
• functional disorders;
• neurological diseases;
• prostatectomy;
• genetic predisposition.

Pathogenesis

Urinary incontinence in men can occur due to internal or external causes. For example, it is often caused by unsuccessful surgical intervention in the genitourinary organs: it can be the removal of tumors, therapeutic manipulations on the urinary tract and so on. Infections affecting the bladder, prostate gland, urethra also play a significant role. In severe cases, incontinence may be a consequence of adenoma or prostate cancer.

Older patients may get this problem due to surgery for adenoma, but sometimes incontinence is the result of a circulatory or neuroregulatory disorder.

The basic predisposing factors are considered to be central nervous system disorders, such as multiple sclerosis, Parkinson's disease, and so on. The second place is occupied by toxic effects on the CNS observed in chronic alcoholism or endocrine diseases.

In some patients, the cause is "hidden" in a violation of the interposition of internal organs, which often occurs with complete lack of physical activity, or with excessive physical exertion, deterioration of the characteristics of the urovesical musculature and sphincters. Less often, the problem is associated with radiation therapy, the influence of psychotropic drugs, diuretics. [4]

Symptoms of the male urinary incontinence

Urinary incontinence - for example, during a night's rest - may be the only sign of disease, the complaint with which the patient comes to the doctor for help. In some patients, abnormal urination occurs without any additional symptoms, while in others there is anxiety, night awakenings, sleep disturbances.

Urinary incontinence in men in sleep is noted at different intervals. At the same time, a different volume of fluid is excreted - from 150-350 ml and more. A certain number of patients indicate urinary incontinence not only at night, but also during the day - such urinary acts are often painful, commanding. Urinary incontinence is particularly common in the cooler seasons.

The first signs in the "classic" variant of urinary incontinence are as follows:

• uncontrollable discharge of urinary fluid, either trickling or in drops, observed between acts of controlled urination (e.g., at night);
• a feeling of incomplete urination;
• inability to hold back urine output at the moment of urge.

From practice, the older the patient, the richer the clinical picture of incontinence. For example, in old age there is sometimes simultaneous incontinence of urine and feces in men, which is especially common in persons who have previously suffered from alcohol dependence. In such a situation, medication alone is not enough: it is important to apply a comprehensive approach, including LFK and Kegel exercises.

Urinary incontinence in young men occurs with alcohol intoxication: the use of large amounts of alcohol leads to damage to many parts of the brain, which affects the work of the urinary system. Urine leakage due to heavy physical labor, lifting and carrying heavy objects, which is directly related to a short-term and strong increase in pressure in the abdominal cavity, is not uncommon.

Lack of control over nocturnal urination is the most common, but not the only symptom of the problem.

Urinary incontinence in men after 50, 60, 70 years of age is often accompanied by:

• with daytime urinary leakage;
• fecal incontinence;
• restlessness, sleep disturbances;
• constant anxiety, panic attacks;
• pain in the external genital area;
• discomfort in the urethra during urination;
• cloudy urine;
• elevated body temperature;
• frequent urinary urges, polyuria.

Urinary incontinence in elderly men, senile urinary incontinence is almost always accompanied by various somatic disorders associated with the general condition of the body and the presence of other, more often chronic, diseases. The most common are insomnia or drowsiness, disorders of digestive processes and appetite, heart rhythm disorders, shortness of breath, problems with potency, dizziness. Psychological signs of depression, characteristic of elderly patients suffering from urinary incontinence, may be "masked" by numerous bodily complaints.

A complex complex problem is urinary incontinence in men after surgery, after removal of the prostate. As a rule, such disorders are caused by impaired innervation, compaction of the musculature of the prostatic segment of the urethra, the development of scarring changes. This generally entails dysfunction of the urethral sphincter. It is worth noting that in most patients the problem disappears for about a year after surgery.

Every second patient hospitalized with a stroke has some degree of urinary incontinence. Among the most common symptoms are leakage during laughter or coughing, uncontrollable urge to urinate. Urinary incontinence in men after a stroke is especially pronounced, which negatively affects the general emotional mood of patients, can cause depression and even unwillingness of a person to return home after treatment in the hospital. It is important to let the patient understand that his problem is solvable, and the disease can and should be treated in order to subsequently live a full life again without changing its quality. [5]

Stages

According to information provided by the International ICS Society, there are 4 stages of urine loss:

• I - mild stage, with a loss of less than 10 g when performing the Pad test in 1 hour;
• II - moderate stage, with a loss of 11 to 50 g of urine in a 1-hour Pad test;
• III - severe stage, with a loss of 51 to 100 g of fluid when performing the Pad test in 1 hour;
• IV - very severe stage, with a loss of more than 100 g of urine in 1 hour when performing the Pad test.

Forms

In medicine, there are several variations of urinary incontinence in men, which directly affects the determination of the treatment scheme:

• Mild urinary incontinence in men may be due to malfunctions in the balance between the brain, a man's nervous system and his musculature. Often the mild degree of the problem is eliminated by adjusting the lifestyle, sleep and rest regime, eliminating stressful and other provoking factors.
• Urge urinary incontinence in men is a condition in which the patient is aware of the urge to urinate, but cannot control it and cannot tolerate it until he can go to the toilet. This type of incontinence is typical for patients with diabetes mellitus, Parkinson's disease, and post-stroke conditions.
• Alcoholic urinary incontinence in men is associated with several causes at once: it is a depression of higher nervous activity (depression of consciousness and loss of the ability to control the physiological urge of the body), increased diuresis (alcohol increases the volume of fluid produced), as well as a decrease in the tone of the pelvic musculature. This type of problem disappears on its own after alcohol withdrawal.
• Sleep urinary incontinence in men is called nocturnal enuresis and refers to the involuntary excretion of urine during a night's rest not due to a physical disorder (somatic disease). Nocturnal incontinence may be closely related to nocturia, which is frequent nocturnal urination.
• Frequent urination, urinary incontinence in men can be caused by infectious processes, intestinal disorders, intoxication, as well as other causes that disrupt neuromuscular activity and negatively affect the function of the bladder. If the external provoking factor is eliminated, it is possible to achieve independent adjustment of the urinary excretion process.
• Male urinary drip incontinence is also called overflow incontinence, or paradoxical urethra incontinence. This type of disorder is often due to blockage of the urethra by a hypertrophied prostate or other tumor processes. As a result, urinary fluid is excreted in small amounts, but often in drops.
• Urge urinary incontinence in men is one of the names for urge incontinence, the features of which we have discussed above.
• Stress urinary incontinence in men is the most common and is the "loss" of urinary fluid during physical exertion, laughter, coughing, or other action that causes an increase in abdominal pressure.
• Partial urinary incontinence in men is often triggered by an external factor and goes away once this influence is over. The most common causes of such partial incontinence are cystitis, heavy alcohol consumption, diuretic intake, constipation etc.
• Persistent urinary incontinence in men is often mixed and is determined by the combined manifestation of urgency and stress mechanisms. Enuresis with bladder overflow is often the result of reduced detrusor contractility, urethral distension and insufficient sphincter function.
• Urine leakage after urination in men is otherwise known as "dribbling": the problem occurs even if the patient takes time after the urinary act, trying to eliminate "every last drop". In turn, two types of leakage are distinguished: after the end of the urinary act, as well as residual dribbling. This is due to incomplete emptying of the bladder during urination: fluid accumulates in the urinary tract, for example due to prostate adenoma or weakness of the pelvic muscles.

Complications and consequences

Among the most frequent complications of urinary incontinence in men, experts emphasize infectious-inflammatory processes and other diseases of the urinary system. In addition, patients suffering from incontinence often form insecurity and low self-esteem, increased anxiety, neuroses occur. It becomes difficult for such people to leave home for long periods of time or stay overnight with friends or relatives. The quality of life of men with urinary incontinence is markedly reduced, various mental disorders develop. A sick person can become depressed, irritable, withdrawn or aggressive.

To prevent the development of such malfunctions, it is necessary to try to cope with the problem - the earlier, the better. Treatment should be comprehensive, with strict compliance with all the recommendations of the doctor. Of great importance in the success of treatment belongs to the family of the sick person: only if there is complete understanding, trust and support can be sure of a positive result of therapy.

Diagnostics of the male urinary incontinence

The standard urologic examination that is ordered for urinary incontinence in men usually includes:

• Doctor's consultation, with collection of anamnestic data, differential diagnosis, determination of further diagnostic steps;
• urologic examination with palpation of the seminal canal and testicles;
• Ultrasound of abdominal organs and urinary tract;
• A coded ultrasound study of the pelvic and scrotal vascular network;
• a rectal prostate ultrasound procedure.

The following tests are recommended:

• general blood analysis (detailed formula, including the study of the level of male hormones);
• urinalysis;
• PSA (cancer marker) blood test.

Instrumental diagnosis is often complemented by uroflowmetry, a technique for determining impaired lower urinary tract urodynamics, i.e. Detrusor contractility. In simple terms, uroflowmetry is a procedure for direct recording of the volumetric velocity of urine flow during the urinary act. This is necessary for a summary assessment of the tone, contractile activity of the musculature and patency of the urethra. [6]

Also practiced are cough tests (with a full bladder), radiation, endoscopic, urodynamic and functional examinations.

Differential diagnosis

Differential diagnosis should be made with such diseases:

• Oligophrenic urinary disorder (in boys with congenital dementia at 7-10 years of age);
• Urinary disorders in schizophrenia and schizophrenia-like symptom complexes;
• manic-depressive syndrome;
• Hyperdynamic syndrome (in boys 4-10 years old);
• epilepsy;
• neurotic or neurotic-like enuresis.

Quite often, under the guise of urinary incontinence in men, a completely different disease manifests itself, in which incontinence itself is only a background sign. Therefore, it is important to review all possible pathologies associated with incontinence:

• allergic diseases;
• endocrine disorders;
• nocturnal apneas or incomplete respiratory obstruction.

Treatment of the male urinary incontinence

Urinary incontinence in men is not always a pathology that requires special therapy. For example, in children and adolescents, the doctor can limit himself to general recommendations, consultation with a psychotherapist. It is necessary to adhere to a drinking regimen, exclude any stress factors, adjust nutrition and digestive processes, normalize sleep.

In adults, the treatment tactics are significantly different. Medication or even surgical treatment is often used, as urinary incontinence often develops against the background of chronic infectious processes, traumatic injuries, disorders of urine excretion. [7]

Possible treatments are considered to be:

• the use of a synthetic vasopressin analog to restore endocrine balance;
• Relieving smooth muscle spasms with antispasmodics;
• Antibiotic therapy to get rid of microbial infections;
• psychotherapy for stress and anxiety;
• Plasty of anatomical abnormalities of the urinary tract.

How to treat urinary incontinence in men at home?

Often a man can solve the problem of urinary incontinence on his own, for example by changing some of his own habits. If incontinence occurs during nighttime rest, it can be corrected by limiting fluid intake after 2:00 a.m. The problem can be eliminated.

It is also important to avoid foods that increase urine production, such as watermelon, strawberries and cranberries. Popular drinks such as coffee, black or green tea, alcohol (including beer) also have a diuretic effect and should be avoided.

It is recommended to follow the so-called Krasnogorsky diet:

• Eat some salted fish or salted black bread before going to bed;
• The last sip of water for the day can be made four hours before going to bed.

It is necessary to properly organize the place for sleeping. In case of nocturnal urinary incontinence in men, you should choose a mattress with a firm base: the spinal column will be held and the transmission of nerve signals will be improved.

Sometimes experts recommend setting an alarm clock to wake the patient up about 3 hours after bedtime - to use the restroom.

It is imperative to take steps to avoid stress and phobias. Men who are balanced and calm are much less likely to suffer from urinary incontinence.

Pills for urinary incontinence in men

To normalize bladder activity, anticholinergic drugs are often used. In pharmacy chains, such drugs are usually represented by Driptan, Urotol, Novitropan, Uroflex, Detrusitol, etc. In addition to them, you can use drugs of muscle relaxing action - for example, Vesicar, Toviaz, etc.

If urinary incontinence in men is associated with prostate adenoma, the doctor may prescribe hypotensive drugs from the group of α-adrenoreceptor blockers - for example, Terazosin. This medication dilates arteries and veins, reducing total peripheral resistance. The dosage of Terazosin is determined individually for each specific patient. Most often, the drug is effective in a daily amount of 1-5 mg in 1-2 doses, but the result may become noticeable not earlier than 2 weeks from the beginning of treatment. [8]

Medicines that your doctor can prescribe

Name of drug	Characterization	Dosage and side effects
Pantogam	Normalizes brain function, promotes proper transmission of impulses from the bladder to the brain.	Prescribed 2 tablets half an hour after meals, three times a day, for three months. Side symptoms: allergic rhinitis, conjunctivitis.
Glycesed	Demonstrates sedative effect, relieves tension, improves sleep while maintaining its sensitivity.	Apply sublingually, twice a day, for 2-3 weeks. Side effects: allergy.
Phenibut	Optimizes brain metabolism, stabilizes sleep, reduces anxiety.	Take 1 tablet daily for 7-10 days. Side effects: hepatotoxicity, allergies, sleep disorders, emotional lability.
Melipramine	Increases bladder capacity, optimizes sphincter function, relaxes bladder walls.	It is prescribed 1 tablet three times a day for 2 weeks. Side symptoms: tachycardia, hypotension, tremor, paresthesias.
Radedorm	Relieves spasm of the bladder muscles, improves night sleep.	Take 1 tablet half an hour before going to bed. Side effects: drowsiness, loss of energy, slow psychomotor reactions.
Driptan	Eliminates bladder hypersensitivity, relaxes smooth muscle, reduces contractile activity of the bladder.	Take 1 tablet up to 3 times a day (necessarily once - before bedtime). Side effects: constipation, nausea, confusion, dizziness.
Spazmex	Increases sphincter tone while relaxing the urethral walls.	Take 1 tablet up to 3 times a day before meals, for 3 months. Side effects: dry mouth, tachycardia, nausea.
Desmopressin	Allows you to reduce the volume of urinary fluid produced.	Dosage is determined individually. Treatment is prolonged - up to 2-3 months. Side symptoms: edema, headache, cramps, rhinitis, nosebleeds.
Minirin	Slows down kidney function, reduces the volume of urinary fluid produced.	Take one dose before going to bed. Treatment is continued for up to 3 months. Side effects: increased blood pressure, hot flashes, cramps.

Vitamins to correct bladder function

Multivitamins and biologically active supplements are advised to take courses lasting from two weeks to 2 months. It is desirable to alternate drugs, consulting with a doctor in advance.

• Prolite is a herbal remedy that improves the functional ability of the urinary system. Take 5 capsules three times a day.
• Prolite Super is a prolonged herbal remedy that prevents the development of inflammatory pathologies of the bladder and urethra. It is recommended to take 1-2 capsules three times a day with food.
• Monurel Previcist - cranberry extract recommended for the prevention of cystitis and other diseases of the urinary tract. Take 1 tablet of the product once a day.
• Uroprofit is a herbal preparation based on cranberry, bearberry, horsetail and ascorbic acid. It is taken 1 capsule twice a day with food.
• Cystotransit is a drug with antispasmodic and anti-inflammatory action.

Also as part of the complex treatment of patients with urinary incontinence necessarily prescribe vitamin A, tocopherol, B vitamins, niacin, ascorbic acid.

Male urinary incontinence devices

Urinary incontinence significantly complicates the life of both the man himself and his surroundings. In some cases, patients are recommended to use various special devices that will help minimize restrictions and help to do simple and usual activities as before. Thus, urological pads and special absorbent panties (like "diapers") will help, if necessary, to leave the house and even go to work, without fear of an accidental episode of incontinence.

Diapers for men with urinary incontinence allow you not to feel discomfort in bed during rest, and also greatly facilitate the work of caring for a bedridden patient. These products are available in different types and varieties, so they can be matched to any degree of incontinence.

If the incontinence problem is small and only manifests itself in a drip of urine, special urological pads and retention underwear can be used to cope with the problem. Underwear for urinary incontinence in men "hides" the pad, so that it is not visible under clothing - even if it is an impeccable business suit. The use of such a tandem "pad-underwear" allows the patient to do the usual favorite activities, attend work and even actively relax.

Other popular hygiene items include special urine collectors designed to receive and collect urinary fluid. Urine collectors for male incontinence can be portable (for permanent wear), bedside (for attaching near the bed), disposable or reusable. The usual collection includes a container for urine, a fastening accessory, and tubes to drain the fluid. Sometimes the containers are filled with a special gel that can absorb for 2 days without emitting an unpleasant odor.

Another device is a urological male urinary incontinence clamp called the Cunningham penile clamp. This is a relatively easy-to-use device that provides the strictly necessary pressure on the urethra to stop the uncontrolled outflow of urinary fluid. The clamp is fixed approximately in the middle of the penis, using the most comfortable level of compression necessary to control urinary output.

Physiotherapeutic treatment

Physiotherapy can often help men with urinary incontinence. There are several procedures known to solve this problem:

• Electrosleep - the procedure helps to normalize the nervous system. Recommended for men suffering from neurological urinary incontinence.
• Darsonval on the bladder projection area - helps to improve the tone of the muscles of the urethrovesical sphincter.
• Magnetotherapy - eliminates bladder spasm, which often leads to urinary incontinence.
• Electrophoresis - stabilizes nervous system function.

Additionally, reflexotherapy is used to promote the formation of so-called "watchdog reflexes":

• paraffin therapy, ozokerite, mud treatment on the lumbar region;
• hydrotherapy ("rain", circulating shower, coniferous-nitrogen, pearl, salt baths;
• acupuncture.

In childhood, the treatment is often practiced in the form of communication of the child with dolphins, horses, other animals.

Folk treatment

Folk treatments can help the body to cope with the problem faster and prevent recurrence of urinary incontinence.

• 2 tsp. Plantain herb pour 200 ml of boiling water, insist under a lid for an hour. Filter and take 1 tbsp. L. 30 minutes before each meal.
• 5 tsp. Sage is poured 200 ml of boiling water, insist for several hours, then start taking 200 ml three times a day.
• Drink a decoction of onion husks, a sip a few times a day.
• Add dry ground wormwood, dill seeds to food.

Properly selected folk remedy will not replace drug treatment, but will improve its quality and help to eliminate the functional disorder faster.

Herbal treatment

Folk recipes in the treatment of urinary incontinence may well be used. But it should be remembered that all herbal components, infusions, etc. Can be taken only after obtaining the doctor's consent. Among the most popular folk remedies are especially relevant are considered such:

• lingonberry morsels or tea;
• an infusion of St. John's wort;
• a decoction of bay leaves;
• yarrow herb infusion;
• infusion of arnica flowers or decoction of the rhizome of the plant.

In addition, herbal remedies with sedative and calming properties are indicated. Such plants include valerian, licorice, motherwort, shepherd's purse, fennel.

Dill for urinary incontinence in men is considered an excellent and effective remedy. To prepare the infusion of dill seed in an amount of 1 tbsp. Pour into a thermos, pour 200 ml of boiling water, cover and insist overnight (or eight hours). The resulting remedy is drunk the morning after sleep, on an empty stomach. So repeat daily for 10 days. Then there should be a break of 10 days, after which the course is repeated again.

Homeopathy

In many cases, homeopathy has a good effect on urinary incontinence. This method has long been successfully used to treat women, men and even children. However, only a homeopathic doctor can prescribe such treatment, taking into account not only the characteristics of the disease, but also the individual characteristics of the patient.

For example, homeopathic remedies based on Phosphorus can be used to treat men with a sociable nature who prefer to drink cool drinks. Sepia-based remedies are recommended for patients who experience urinary incontinence while laughing or coughing, and at night during the first two hours after falling asleep.

Pulsatilla is indicated for those who suffer from infectious and inflammatory processes of the genitourinary sphere, as well as for hyperemotional, sensitive and capricious natures.

Gelsemium is prescribed if urinary incontinence is associated with anxiety and stressful situations. Natrium muriaticum is indicated if the problem occurs against the background of a difficult situation in the family - for example, divorce, loss of loved ones, etc.

Dosages are always individualized and determined on a case-by-case basis.

Surgical treatment

Operative treatment is performed:

• for acquired stress urinary incontinence;
• in mixed incontinence with a dominant stress component;
• when the disease is rapidly worsening;
• in the absence of efficacy of medical treatment in patients with stage II and III incontinence.

One of the main methods of surgical intervention is the implantation of an artificial urethral sphincter, a prosthesis that replaces the patient's own sphincter, which is failing. The success rate of such an operation is estimated at 75%. In about 20% of cases, a second intervention may be required to correct the function of the implant.

A contraindication to surgery can be:

• urethral stricture;
• infectious and inflammatory processes of the urinary tract;
• urethral diverticula;
• overactive bladder;
• shriveled, low-volume bladder.

The operation is performed through penoscrotal access or through a perineal incision. The patient stays in the hospital for about three days and the catheter is removed 24 hours after the operation. The sphincter can be activated only after its final engraftment - that is, about a month and a half after its installation. The patient is put on the register with a mandatory regular annual visit to a urologist. [9]

Gymnastics, Kegel exercises for men for urinary incontinence

The pelvic diaphragm is located in the posterior part of the perineum in a triangle-like shape: its upper point is directed towards the coccyx, and the lateral corners face the sciatic tubercles. Large clusters of muscle hold the internal organs and retract the rectovaginal and urethral outlets. When trying to hold back the urge to urinate, you can clearly feel the muscles responsible for holding back the urinary fluid. If you are able to control these muscle groups, you can hold back urination to prevent the development of incontinence. For this purpose, the Kegel technique is used - special exercises affecting the main diaphragmatic points.

Practicing such exercises should be done on a regular basis:

• during urination, stop the stream for a couple of seconds and then continue urinating (do not allow the urethra to be clamped with your fingers);
• If you have an extreme erection, hang a towel over the penis and try to lift it with the perineal muscles;
• tense and relax your perineal muscles throughout the day, about 25 movements per day.

Experts claim that the Kegel technique is an affordable yet effective treatment for male urinary incontinence. Improvements are observed in 70% of patients.

Exercise for urinary incontinence in men

LFK exercises allow you to restore the weakened muscles responsible for adequate bladder function. Here are the most effective and popular exercises:

1. The patient lies on his back, places his arms along the body, spreads them apart and places them palms up, inhales deeply. Bring the palms together over the chest, bend the elbows and place the arms along the body again, gradually exhaling. The number of repetitions is 4-6.
2. The patient lies on the back, arms along the body. Alternately touch one and the other foot to the thigh of the opposite limb. The number of repetitions is 6-8.
3. The patient lies on his back, arms bent at the elbows. The patient rests on the elbows and the back of the head, rises up, flexes on the inhalation and lies back down again on the exhalation.
4. The patient lies on the stomach, bends the elbows and places the hands near the face. With the forearms resting on the forearms, lift the head and upper torso, inhale. With exhalation returns to the starting position.
5. Lying on the stomach, place hands under the forehead area. Lift straight legs alternately, simultaneously tensing the anus muscles.
6. The patient lies on his back, legs bent at the knees, pressed against each other. Knees first on the left side, then on the right side (head and shoulder girdle should not move).
7. Lifts the pelvic area with the focus on the elbows and heels, while tensing the anus muscles. Number of repetitions - from 3.
8. From a supine position, lift straight legs, spread them apart, bend knees and straighten legs again. Return to the starting position.

Do not rush when performing exercises. The number of approaches should be increased gradually.

Prevention

Urinary incontinence can affect absolutely any man, regardless of age. To reduce the likelihood of this problem, it is necessary to follow a number of recommendations from specialists:

• to stop smoking;
• minimize alcohol consumption;
• follow the principles of a balanced diet;
• avoid sweets, spicy spices and large amounts of salt in foods;
• prevent constipation;
• control blood sugar and cholesterol levels;
• lead an active lifestyle, engage in physical exercise.

Kegel exercises are considered a specific method of preventing urinary incontinence.

Forecast

The final criterion for a favorable outcome of the treatment is the restoration of normal urination, the absence of residual urinary fluid volume and the absence of symptoms of reoccurrence of the problem.

The surgical intervention is successful in more than 70% of cases, but more than 20% of patients continue to suffer from urinary incontinence. Sexual dysfunction (discomfort during sexual intercourse) can be a complication of this surgery.

In general, urinary incontinence in men is considered to be a solvable problem, provided you see a urologist early and follow all of his recommendations.