Bladder control problems are common in men, especially as they get older. With the right advice and treatment the majority of those affected can have significant improvement.
Key points about bladder control problems in men
- Although bladder control problems are common, it is important to seek help so you can get help for your symptoms and your doctor can rule out any serious conditions.
- Bladder control problems can be due to a number of reasons such as prostate cancer or prostate enlargement.
- Symptoms are often accepted as part of the natural aging process but it’s important to know there are treatments out there that can help.
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Normal bladder control
The production of urine is not under our voluntary control. However, as adults, we have developed the ability to recognise when our bladder is full, and to be able to hold on to urine until we reach a toilet. This means we have control over when and where we will pass urine.
This control is possible because of messages passing between the brain and the bladder, and our ability to interpret these messages. We can learn to use this mechanism to delay passing urine.
The bladder and the urethra
Structures that help keep urine in the bladder are the pelvic floor muscles and the urethral sphincter.
The pelvic floor muscles help to hold all of the pelvic organs in place. When the pelvic floor muscles are strong, the urethra and bladder cannot move out of place. This helps keep the urethra closed, so urine cannot leak from the bladder.
The urethral sphincter is a band of muscles around the urethra. When these muscles are strong, they squeeze tightly and keep urine in the bladder. When you want to urinate you can relax these muscles.
What are the signs of bladder control problems?
Most symptoms of bladder control problems are due to the flow or storage of urine. Some men get a mixture of symptoms. Most symptoms are usually not serious but sometimes they can be due to a serious condition like prostate cancer. It’s important to see a doctor if you have any of the following symptoms – even if they are mild:
- Struggling to start peeing (called hesitancy).
- Producing a slow stream of pee.
- Taking a long time to pee.
- Wetting the bed.
- Peeing more often than usual (urinary frequency).
- After-discharge of pee.
- A feeling of incomplete bladder emptying.
- Having a sudden urge to pee (urinary urgency).
- Leakage of pee before getting to the toilet (urinary incontinence or overactive bladder).
- Leakage from coughing, sneezing, laugh or exercising (stress incontinence).
Some symptoms may not be due to bladder control. For example, as we get older we make more urine at night and this has nothing to do with your bladder.
There are some symptoms that you need to seek urgent help for, as they could be due to an infection, prostate cancer or kidney failure. These need urgent treatment.
|Call healthline or see your doctor urgently if you have any of the following symptoms:|
What causes bladder control problems in men?
As you get older, your body changes. The muscles in your bladder change and can become weaker so your bladder may not be able to hold pee in. Your prostate gets bigger which can sometimes affect the flow of urine from your bladder. Also, with older age, the body tends to store fluid during the day and gets rid of it at night while lying flat. This results in extra urine production at night.
Your prostate gland
The prostate is a small gland found in men. It is about the size of a walnut and sits just below your bladder. Its job is to secrete a milky fluid that becomes part of the semen and nourishes the sperm. Because the prostate gland is located close to the bladder, it can affect the flow of urine from your bladder. This causes a condition called benign prostatic hyperplasia (BPH), also called prostate enlargement. The prostate often gets blamed for many bladder problems but it’s not always at fault.
Other causes of prostate-related urinary conditions include prostatitis, infection or prostate cancer. Read more about common prostate conditions.
Other causes include:
- medical conditions such as urinary tract or bladder infection
- surgery such as spinal surgery or prostate surgery
- bladder tumour or stone
- medications such as diuretics (water tablets)
- high amounts of alcohol and caffeine
What can I do if I have bladder control problems?
Bladder control problems don’t have to ruin your lifestyle. See your doctor if you have symptoms and they can find out what is causing your bladder problems and give you the help you need. This could include self-care measures, medication, exercises or referral to a specialist. A surgical fix should always be a last resort.
Don’t hesitate to seek help. Your doctor will be able to tell you more about your options.
See self care for bladder control problems for detailed information on diet changes, continence products, pelvic floor exercises and bladder training.
Continence NZ Information and education on continence topics. Also, a free helpline phone 0800 650 659.
Urinary symptoms in men NZ Continence Association
Continence information – adults NZ Continence Association
Promoting good bladder and bowel health NZ Continence Association
Bladder Diary with instructions. The Continence Foundation of Australia
Bladder The Urology Foundation
Consultant urologist urges men to seek advice for urinary symptoms NHS, UK, 2017
Urinary problems Ministry of Health, NZ, 2014
Information for healthcare providers
Red flags for referral for urinary incontinence in men BPAC, NZ, 2013
Urinary incontinence BPAC, NZ, 2013
Continence screening form for residential care Deakin University, Continence NZ
Continence assessment and care plan Continence NZ
Diagnosis and management of prostate cancer in New Zealand men Ministry of Health, NZ, 2013