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Let’s talk about male incontinence: six common questions answered

Incontinence comes loaded with misconceptions, not least that it’s a women’s or older person’s problem. This could be why so many younger men stay silent when urinary incontinence strikes. Here, we look at what causes a condition that is far more widespread than many think – and how it’s eminently treatable.

How common is male incontinence?
A quarter of men over the age of 40 experience some form of urine leakage according to research by the global health and hygiene company Essity. And, in the US, the National Association for Continence says that incontinence affects as many as 15% of men aged 15-64, which belies the myth that it’s only postpartum or menopausal women who suffer from it.

The prevalence of male incontinence does little to quash its stigma, however. A study carried out by Essity in the past year found that incontinence was seen as even more difficult to discuss than depression. Many doctors speak of male patients using their wives’ sanitary pads so they don’t end up with a soggy pair of boxers, or staying indoors due to “bladder leash” – the fear of not being able to locate a loo when leaving the house.

Related: ‘I was a ball of self-hate and panic’: incontinence expert Luce Brett on the secret shame of bladder weakness

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When is male incontinence most likely to strike?
There are different types of incontinence, with men most likely to experience “urge incontinence”. If you’ve ever felt a strong, unexplained impulse to pee, but find you’ve only got a few seconds to sprint to the bathroom, it’s probably urge incontinence. That’s why some men suffer “latchkey incontinence”, the sensation that the floodgates are about to open the moment you twist the key in your front door.

Our internal plumbing is usually to blame for leakage, particularly overactive detrusor muscles. When these muscles contract too often (perhaps because you’ve had too much alcohol, too few fluids or even because you’re constipated), it can result in an uncontrollable urge to urinate at unforeseen moments, such as when you hear running water.

Other factors that may make it harder to avoid dampness down under include being overweight or having had surgery for prostate cancer, which can result in weakened muscles.

Men are also likely to experience post-micturition dribble, which causes a map-like stain to form on underpants after urinating. It’s often down to weakened pelvic floor muscles.

Isn’t male incontinence something that only happens to older men?
Urinary incontinence does occur more regularly with age, largely thanks to men owning a prostate gland, which becomes grouchier with each passing birthday. However, one 2011 study published by the urological journal BJU International found that 5.5% of men aged 25-29 have experienced it.

What other types of incontinence are there?
Men can also experience stress incontinence. That’s not “stress” as in feeling overwhelmed by a bulging inbox, but “stress” as in pressure. It happens when the bladder is put under sudden strain, such as coughing, sneezing, laughing or lifting weights in the gym, all of which can cause urine to leak, possibly because the pelvic floor muscles are weak.

Incontinence can also be caused by overflow incontinence (also known as chronic urinary retention). This is when the bladder doesn’t entirely empty, resulting in a man passing small trickles of urine regularly, along with a feeling that the bladder is constantly full.

How can I manage my incontinence so I can lead a normal life again?
For starters, go and get a checkup with your GP to help you find out the cause. A trip to your GP may result in you being prescribed a course of antibiotics, or given advice on how lifestyle choices (see below) could alleviate symptoms.

Until that’s addressed, and any changes kick in, many men have found the easiest way to manage their urine leakage is by using incontinence products, which allow them to enjoy the social activities they did before.

Unsure where to start? Try TENA’s free Keep Control sample pack, which arrives discreetly packaged and allows you to road-test the incontinence tech that works best for you. This could be absorbent protective pads or underpants that look just like normal boxer shorts but keep nether regions dry.

What else can I do to prevent bladder attacks?
Not gulping down endless cups of tea and coffee during your working day can help, as caffeine is a diuretic that can increase the amount of urine you make. That said, it’s important to drink enough fluids so try to sip plenty of water throughout the day. Eating a healthy diet and keeping to a good weight is also beneficial, as being overweight puts pressure on the bladder.

And don’t forget the pelvic floor, the muscles that hold the bladder and rectum in place. Men have less active pelvic floors than women so any exercises that strengthen them, such as pilates, are great.

Learn more about pelvic floor exercises for men at tena.co.uk/men/how-to-keep-control/mens-pelvic-floor-exercises