Types of Incontinence
- Urge Incontinence – Leakage associated with an overwhelming need to urinate also known as overactive bladder or OAB (Gotta go, gotta go!)
- Stress Incontinence – Leakage during physical activity that increases intra-abdominal pressure, i.e. lifting, exercising, sneezing, and coughing
- Mixed Incontinence – Combination of the above
- Orgasmuria – a subtle form of stress urinary incontinence is the leakage of urine that only occurs during sexual activity and orgasm
Stress Urinary Incontinence
Stress urinary incontinence is caused by damaged or weakened urethral sphincter in the setting of a bladder that is able to store urine adequately. The sphincter is the muscle that controls the flow of urine. When damaged, the sphincter loses the ability to squeeze and close the urethra, resulting in leakage.
Stress Incontinence After Removal of Prostate
Stress urinary incontinence occurs most often after prostate cancer surgery, but can also rarely occur after trans-urethral prostate surgery and radiation therapy for prostate cancer. In the process of removing the prostate cancer, parts of the muscle tissue that help control urine flow may be damaged. Differences in the length of the urethra located between the tip of the prostate and the sphincter muscle, also determines which patients are more likely to be incontinent after prostate cancer surgery. Patients with a longer segment of the urethra in this specific anatomical area will have a greater likely hood in being continent. Patients with a very short segment of this urethra are at risk of developing incontinence following the cancer operation. In some cases scar tissue forms at the point where the bladder was reconnected to the urethra, obstructing urine flow as well as preventing proper function of the sphincter muscle. After removal of the prostate, it is not unusual to have partial incontinence. For most this is a temporary condition, which in the majority of cases resolves within a year or so. If the incontinence continues beyond 18 months to 2 years, it is unlikely to improve on its own and a doctor should be consulted. A narrowing of the connection of the bladder with the urethra also known as a stricture may develop after prostate cancer surgery. Narrowing of urinary stream, urinary infections and inability to completely empty the bladder may subsequently occur. This can also lead to frequent urination and in some cases overflow incontinence.
Orgasmuria is a subtle form of stress urinary incontinence is the leakage of urine that only occurs during sexual activity and orgasm. This is noted in up to 30% of men following prostate cancer surgery. This condition is very disturbing for many men and most will refrain from sexual activity because of this condition. However it can be easily fixed with a male sling.
OAB is defined by having several urinary symptoms including urgency with or without incontinence, frequency of urination during the day and at night (nocturia). This is condition is often referred by urologists as lower urinary tract symptoms abbreviated to LUTS.
Overactive Bladder is a common medical condition that affects up to 542 million Americans and Europeans. In the US 16.6% of the adult population suffers from OAB. Of those 6.1%or 12.2 million will have severe OAB, which we define as “Wet” involving accidental leakage of urine. OAB is not a natural part of aging and should be treated– you can do something about it. It is not a result of drinking too much fluid and neither does it exist because you have a weak bladder. The risk of having an OAB increases with age. At 60 or older approximately 5% of men are incontinent due to OAB. Certain medical conditions such as diabetes are linked to OAB and frequent urination at night (nocturia).
In a study published in the March 2008 issue of the journal Diabetes Care diabetes is positively associated with irritative lower urinary tract symptoms (LUTS) and nocturia but not benign prostatic hyperplasia (BPH).” The researchers found that diabetes was associated with irritative LUTS and nocturia “consistently across racial groups.” Furthermore, “The relationship between irritative LUTS and diabetes was greater in black men.”
If you often experience a strong uncontrollable urge to urinate with barely any time to make it to the bathroom, or if your sleep is disturbed 2 or more times a night with the need to rush to the bathroom, you may be suffering from OAB and you should contact a health care professional for treatment.