Incontinence in men

Summarized by Robert W. Griffith, MD
July 31, 2000 (Reviewed: December 13, 2002)

Urinary incontinence is usually thought of as a female problem. However, it's surprisingly common in men of all age groups. In fact, it's been reported as being only half as frequent in men as in women, which represents quite a sizeable number of sufferers. Unfortunately, men with incontinence rarely discuss it with their physician, so that the necessary attention is not paid to the problem. A recent study on the frequency of male incontinence has been done among U.S. veterans, emphasizing this.

Questionnaires were completed by men who were approached in the waiting rooms of three primary care Veterans Administration clinics in Louisville, Kentucky USA. Information was gathered on age, race, previous surgery, medications taken for urinary symptoms, the frequency of episodes of urine leakage, the severity of this leakage, and whether the person had discussed the matter with his physician. In addition, a quality-of-life assessment was done, to find out how much the problem impacted on the participants day-to-day activities. Anyone who had experienced leakage of urine in the past 12 months was considered to have urinary incontinence.

Almost 1,000 men were approached, and 85% of them agreed to complete a questionnaire. Their average age was 60. Surprisingly, 25% of men aged 40 or below reported incontinence at least once during the past 12 months. All ages over 40 had at least a 30% incidence of incontinence - it was 36% in the 60 to 70-year-olds - but it dropped to 20% in the over-80-year-olds. The amounts of urine loss or the frequency of accidents did not vary in the different age groups.

The results were analyzed to see if there were obvious relationships between incontinence and possible causes. Men who had had prostate surgery or bladder surgery, or who were taking medications for urinary problems, had a significantly increased likelihood of being incontinent (2 to 3 times more likely). Prostate cancer, taking diuretics (water-pills) or prostate medications did not affect the likelihood of incontinence.

Not surprisingly, frequent incontinence was associated with deterioration in some aspects of the quality-of-life. For instance, emotional health, social relationships, physical activity, and travel were all less satisfactory for incontinent men.

Only a third of the men with incontinence had discussed the problem with their physicians. However, three-quarters of them expressed an interest in having a full evaluation and treatment of the problem, if it were offered.

It can be concluded from this study, and others, that male incontinence is a real problem across all age groups, and that it affects men's quality of life. Unfortunately, the sufferers do not often discuss it with their physicians. There is clearly much room for improvement in its diagnosis and management. Sufferers should not suffer in silence, but speak out to their physicians and health providers, in order that more attention is paid to their problem. Only in this way will progress be made in relieving an embarrassing and occasionally distressing condition.

Source

• Urinary incontinence among male veterans receiving care in primary care clinics SH. Smoger, TL. Felice, GH. Kloecker, Ann Intern Med, 2000, vol. 132, pp. 547--551

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