Urinary incontinence affects far more women than men, although it can still pose a considerable problem for many men who need to seek help in the management of their incontinence problems.
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Similar to women, urinary incontinence is more prevalent among men as they age, which is likely to be a result of concurrent health conditions that may cause symptoms of incontinence. Men, in particular, are at a greater risk of developing specific types of urinary incontinence, such as those related to the prostate gland or certain nervous system diseases.
Anatomical advantage of men
The male anatomy of the urinary system is generally considered to be the primary reason for which they experience fewer problems of incontinence in respect to their female counterparts.
In particular, the length of the ureter, which carries urine from the bladder to the urethra to exit the body, is much longer in males, as it covers the length of the penis. This extra space provides the pelvic floor muscles more room to inhibit the flow of urine and prevent incontinence. In addition to these beneficial effects, the length of the ureters also offers a protective action against infections of the urinary tract.
Nervous system disease and incontinence
The nervous system is responsible for carrying messages from the bladder to the brain when it is full and back to the bladder muscles and sphincter when it is time to urinate. As a result of this, any condition that damages nerves in the body has the potential to lead to urinary incontinence.
Men who have uncontrolled diabetes are at risk of nerve damage, which can lead to symptoms of incontinence. Additionally, stroke, Parkinson’s disease, and multiple sclerosis affect the brain and have been linked to problems of urination. Parkinson’s disease, in particular, affects more men than women and is an explanative factor for a greater proportion of adult men affected by that type of incontinence.
An overactive bladder causes the muscles in the bladder to contract and try to excrete urine without higher command from the brain. This commonly results in urge incontinence, during which the man suddenly feels an irrepressible need to urinate and does not have time to reach a bathroom.
Prostate problems
As men age, problems of incontinence tend to become more common, which is likely to be, in part, related to changes to the prostate gland that affect many elderly men.
The prostate gland rests underneath the bladder beside the urethra. An enlarged prostate is a common problem that affects men, which involves swelling of the gland until it is approximately the size of a walnut.
This enlargement can pose a problem to the urinary system, as the size of the prostate gland inhibits the passage of urine outside the bladder. As a result, many men with an enlarged prostate have difficulty voiding their bladder completely and there is usually a residual volume of urine inside the bladder. This then leads to more frequent urination as the bladder fills up, as it can become overfilled and cause overflow incontinence.
Additionally, if a man has undergone surgery to remove the prostate gland due to enlargement or malignancy, he is at high risk of stress incontinence. This is because the pelvic floor muscles are often weakened as a result of surgery, which can decrease the ability to maintain continence during activities like heavy lifting or a sudden cough.
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Further Reading
Urinary incontinence associated with higher odds of future disability