Ask the Experts

Caffeine and alcohol both have diuretic properties which can irritate the bladder and make the symptoms of urinary incontinence worse. You may want to think about cutting them out of your diet if you experience bladder control issues. Additionally, some men find that spicy or acidic foods make their urinary incontinence symptoms worse. You could try keeping track of what you eat and noting how it affects your symptoms so you know what you’ll benefit from cutting out and what you can keep. - Dr. Ken Goldberg

Prostate cancer treatments have greatly advanced and today there are many surgical options for you to choose from. The various prostatectomy techniques spare the nerve bundles that control urinary function, which can reduce symptoms of urinary incontinence post-treatment. In fact, with robotic and laproscopic procedures performed by an experienced surgeon, significant incontinence is very low, occurring in less than one percent of patients. However, each method has its own pros and cons, so it is best to consult your doctor to determine which procedure is best for you. -Dr. Ken Goldberg

Great question, David. While often called a bladder pacemaker, the device is actually a stimulator that works by sending an electrical pulse via a small, implantable device to a nerve that is involved in controlling the bladder. The device can help both men and women regain bladder control, and is often prescribed after other methods of treatment have been explored and proven ineffective. Success rates of the procedures in men are very comparable to those in women. Some studies show that the device works for around 70 percent of patients. To be sure it will work, a temporary device is put in place for about two weeks before implanting the permanent device.

The bladder pacemaker sends a painless electrical stimulus to the nerve fibers that regulate the muscles of the bladder, which allows patients to control the storage of urine. Pacemakers may benefit patients with urge incontinence. Side effects may include discomfort at the pacemaker site, infection and skin irritation. -Dr. Ken Goldberg

Mac, I commend you on your efforts to stay active and maintain a healthy lifestyle. Men are often uncertain about the effects bicycle riding can have on their prostate health. Bike riding should not have a significant effect on your PSA level; however, certain bicycle seats can aggravate prostate symptoms such as urinary incontinence, as they place your body weight directly over the perineal area (between the testicles and anus).

Being active is an important part of maintaining overall health, and bicycle riding is a great way to stay fit. You may want to consider purchasing a “split” bicycle seat, which reduces pressure in the perineal area. -Dr. Ken Goldberg

Typically, the average person urinates four to eight times a day. Frequent urination can be the symptom of a number of health issues. An enlarged prostate can cause more frequent urination, but this does not necessarily indicate the presence of prostate cancer. As a precaution, your husband should be getting regular prostate cancer screenings, and should also discuss his urination frequency with his doctor.

It could also be that your husband is simply drinking more liquids than necessary. If he drinks coffee while traveling, the diuretic properties of caffeine will increase his bladder function. -Dr. Ken Goldberg

Steve, your situation is not uncommon among men in your age group. There are several things that could be causing your nighttime trips to the bathroom, including too much liquid intake in the evening and drinking diuretics such as coffee and alcohol. You could try cutting off liquids a few hours before you go to bed to see if this helps.

Frequent urination can also be caused by an enlarged prostate, though this does not mean the presence of prostate cancer.

If your nighttime bathroom trips continue, you should consult your doctor at your next check-up or prostate cancer screening. -Dr. Ken Goldberg

There are three main types of urinary incontinence and each is identifiable by the symptoms you may be experiencing¹:

• Stress Urinary Incontinence is the most common type of urinary incontinence and is characterized by urine leakage when you exert physical pressure on your body (aka- when you laugh, cough, sneeze, laugh or exercise) that pushes the urine out. You do not leak a lot of urine at one time and usually do not experience urinary incontinence at night.
• Urge Urinary Incontinence can be more common in men who have had prostate surgery. Urge urinary incontinence is when you feel a strong, uncontrolled urge to urinate, have a hard time making it to the bathroom and leak in moderate to large amounts. You may also urinate more frequently than you used to or experience urinary incontinence at night.
• Overflow Urinary Incontinence is a constant leakage of urine and can be more common in men with enlarged prostates. When you have overflow urinary incontinence, you need to urinate frequently, but you have difficulty doing so and your bladder never feels empty.  Usually, when you go to the bathroom there are small amounts of urine and you continue to dribble or leak after urinating.

  For more specific information on the different kinds of urinary incontinence, please visit our Types of Urinary Incontinence section.

• Urinary troubles can be indicators of prostate problems, but that doesn’t necessarily mean cancer. Prostate cancer can be a relatively symptomless disease until it reaches other parts of the body. Approximately 5 percent of prostate cancer cases have urinary problems as the initial symptom.
• Because of the prostate’s proximity to the urethra, changes in size, shape or hormone levels can have a big effect on your urinary health. Urinary problems can sometimes be caused by an enlarged prostate (due to a benign tumor) or infection of the prostate, both of which should be discussed with your primary health provider. ²

• Urinary incontinence is one of most common side effects of prostate cancer treatment and occurs in 39-63% of patients for one year after surgery.³ Many men could see an improvement in symptoms in about 6 months.⁴ Although some men experience symptoms for longer than a year, there are a number of options available to help you treat and manage the condition. Learn more about why prostate cancer treatment causes bladder control issues.

• No. Although many people assume that urinary incontinence is a natural part of aging, it is caused by a variety of factors, such as prostate issues, smoking, urinary tract infections, excess weight and diabetes, which can affect men at any age. Although the prevalence of urinary incontinence increases with age, urinary incontinence is not caused by age and there are treatments available for men of all ages.

• Yes. Strengthening your pelvic floor muscles – the group of muscles located underneath your pelvis – can greatly improve bladder control, thus improving symptoms of mild to moderate urinary incontinence. The pelvic floor muscles are responsible for holding the urine in the bladder when you move about. Strengthening your pelvic floor is done through easy and low-impact exercises and can make a big difference in your recovery time. Learn more about strengthening your pelvic floor muscles.

• There are currently no over-the-counter medicines designed specifically to treat urinary incontinence. If you are interested in medications that may help your urinary incontinence, your doctor can educate you on the various treatment options available.

• It is important that you look for products that are designed specifically for men, which ensures that you’ll be receiving extra protection in the right area. It is also important to evaluate your amount of leakage and purchase products designed to absorb that much liquid. Look for high quality products that fit well and have features such as odor protection and faster absorption rates, which all help you stay comfortable, clean and confident all day long. Learn more about using absorbent products to manage urinary incontinence.

• Dealing with the physical symptoms of urinary incontinence isn’t easy. Trying to feel confident through it all can seem just as difficult. Although you are certainly not alone in your condition, you probably feel like you are. Many men experience a sense of isolation because they are hesitant to participate in the activities they once did or are embarrassed because they think no one will understand. Regain your confidence and get back into your old activities by taking control of your condition and managing the symptoms.