Urinary incontinence in men

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Understanding and treating male urinary incontinence

Discover urinary incontinence in men with Professor François Haab and practical advice for better living with this condition.

Introduction

Urinary incontinence in men manifests as involuntary leakage of urine, which can occur after prostate surgery or develop independently. This condition can be a source of social embarrassment, anxiety, and impact on quality of life. Fortunately, diagnostic and therapeutic solutions exist to limit its effects or even correct it. It is important to consult a urologist at the first signs of urinary leakage to establish the correct diagnosis and prevent the condition from worsening.

What is male urinary incontinence?

Urinary incontinence refers to the involuntary loss of urine , in whole or in part, that cannot be controlled. In men, it can occur in various circumstances:

Leaks after prostate surgery
Involuntary loss of urine during exertion (coughing, physical exertion, lifting heavy loads)
Involuntary loss of urine at rest
Difficulty controlling the bladder (urgency, strong urges, urgency)

These different forms can coexist or evolve over time. Some key figures:

Incontinence after prostate surgery (radical prostatectomy) is one of the most common causes of male incontinence.
Male incontinence is less common than in women, but often more poorly tolerated socially due to the taboo.

Causes and mechanisms

Radical prostatectomy, performed to treat prostate cancer, can damage the urinary sphincters or the nerves controlling continence.
Loss of anatomical or nerve support can lead to urine leakage, particularly when standing or during exertion.
Post-operative incontinence can be transient (a few weeks to a few months) or persistent (beyond 6 to 12 months).
Stress incontinence: leakage occurs when there is an increase in intra-abdominal pressure (coughing, sneezing, lifting heavy objects). This indicates a failure of the sphincter mechanism.
Resting incontinence: urinary leakage unrelated to exertion, often linked to bladder overactivity, high bladder pressures or extrinsic weakness of support.
Overactive bladder / urgency: sudden and irresistible need to urinate, with risk of leakage if the man cannot reach the toilet in time.
Bladder instability: involuntary contractions of the bladder during the filling phase.
Mixed component: a combination of a sphincter defect and an overactive bladder.

What are the symptoms?

Frequent urinary leakage, sometimes in small amounts
Post-urination dribbles
Bags or incontinence pads to address leaks
Frequent urination, urgent need to urinate
Inability to hold urine before reaching the toilet
Psycho-social impact: embarrassment, social awkwardness, isolation, sleep disturbances

Diagnosis

Date the leaks appeared
Timing and circumstances (effort, rest, emergency)
History of prostate surgery
Aggravating factors (obesity, chronic cough, constipation)
Perineal examination
Palpation and testing of perineo-urethral mobility
Prostate health check
Urodynamic assessment: measurement of bladder and urethral pressures, investigation of leakage
Cystoscopy: if urethral lesion is suspected
Post-void residual vesico-ultrasound: evaluation of post-void residual
Voiding diary / pad test: quantification of leakage

Possible treatments

Perineal rehabilitation / perineal physiotherapy
Electrical stimulation or biofeedback
Hygiene and dietary measures: limiting fluid intake, avoiding constipation, weight control
Drug use (in some cases): anticholinergics, beta-3 agonists, etc.
Management of the bladder component (in urge incontinence)
Urethral prostheses: devices designed to ensure artificial continence
Urethral balloons
Periurethral suspension
Placement of a urethral sling to support the sphincter
Artificial urinary sphincter (AUS): the standard solution for moderate to severe urinary incontinence, particularly after prostate surgery
Injection of substances into the urethra (adhesives, volumizing agents) in very mild cases
Associated bladder correction (if overactive)

Why consult Professor Haab?

Thanks to his more than 30 years of experience in urological surgery and in the management of incontinence, Professor Haab offers a personalized and progressive approach.
He first favours the gentlest treatments before considering more invasive procedures (rehabilitation, minimally invasive techniques).
In the event that surgery is necessary, he is proficient in the techniques of placing slings, artificial sphincters and other modern solutions.
The goal: to restore continence, improve comfort and give the patient back their confidence.

Patient Journey

Each patient benefits from personalized support, from the initial consultation to post-treatment follow-up. The process includes a thorough assessment, a clear presentation of the various treatment options, and a gradual approach tailored to each individual’s situation.

Do you suffer from urinary incontinence?

Do you suffer from urinary incontinence and would like a specialist opinion? Professor François Haab practices in Paris and will support you at every stage of your treatment, with scientific rigor and compassionate care. Urology Practice Paris Opéra – Paris 17th Arrondissement. In-person or teleconsultation available. Book your appointment today.

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Urinary incontinence in men

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FAQ – Frequently Asked Questions

What are the causes of urinary incontinence in men?

The most common cause is prostate surgery, particularly radical prostatectomy for cancer. Overactive bladder, neurological sequelae, and prostatic obstruction with overflow incontinence are other possible mechanisms.

Is incontinence after prostatectomy permanent?

No, in most cases. Continence gradually improves over the 6 to 12 months following the procedure, aided by pelvic floor rehabilitation. If leakage persists beyond a year, effective treatments are available.

What treatments are available for persistent incontinence?

Depending on the severity: the male suburethral sling for mild to moderate leakage, and the artificial urinary sphincter, the standard treatment for severe incontinence, which restores social continence in more than 90% of patients.

When should you consult a doctor?

As soon as leaks persist despite rehabilitation, or if they impact your activities and mood, an assessment will be performed to quantify the leaks (pad test) and choose the treatment best suited to your situation.

Pr François Haab's expertise

Chirurgien Urologue à Paris

Urinary incontinence in men: there are solutions.

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