Non-Surgical Treatment of Urinary Incontinence
Male Incontinence Severity Level Guidelines
Life, as you know it does not have to change because you have an overactive bladder. Various treatment options are available.
Medications
Certain medications have been known to decrease symptoms of an overactive bladder. These medications have to be prescribed by your doctor and work by enhancing the ability of the bladder to store urine. Examples of this type of medication are: Detrol LA, Ditropan XL, Vesicare, Enablex and Santura. Medications such as Hytrin, Flomax, Cardura, and Uroxatral relax the muscle of the bladder neck and prostate reducing resistance to flow of urine and the work that the bladder muscle needs to do for urination to occur. With time, and because the force needed to urinate is reduced, the detrusor bladder muscle becomes thinner and more elastic, thus increasing the bladder capacity to store urine.
Procedures
Any procedure that reduces urinary obstruction, generally caused by prostate enlargement, may also alleviate symptoms of OAB. These are described in the BPH section of this web site: Microwave (thermo) therapy, Green Light Laser and trans urethral resection of the prostate.
Treatment options
Absorbent products: Absorbent pads, diapers and garments can deal with incontinence.
Medication: No FDA approved medication for stress incontinence in men. Antidepressants/Antihistamine effect on bladder
Devices
Behavioral modification
Biofeedback
Injectables
Surgery
Male sling
Devices
Clamps: Cunningham clamp, C3-clamp
Advantages:
Non-medical, non-surgical
Easy to use
Works well
Disadvantages:
Bulky
Pressure necrosis
Generally not a turn on
Catheters
Advantages:
Works
Disadvantages:
Attached to a bag
Increased risk of infection
Behavioral modification
Decrease fluid intake
Void frequently
Avoid caffeine, alcohol
Avoid activity that increases intraabdominal pressure
Pelvic floor rehabilitation
a.k.a. biofeedback
Means of teaching Kegel exercises
Objective way to measuring pelvic floor strength
Bulking agents
Collagen (Success rates for collagen ~ 17% after prostatectomy)
Carbon beads
Autologous fat
Advantages:
Relatively safe
Office or outpatient
Long term data available
Disadvantages:
Skin test: delayed hypersensitivity
Expensive
Low cure rate
Repeat treatments
