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Managing Overactive Bladder and Urinary Incontinence in the Male

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Urological Men’s Health

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

This chapter reviews the diagnosis and management of overactive bladder (OAB) and urinary incontinence (UI) in men. OAB is a syndrome characterized by urinary urgency, frequency, and nocturia. In some individuals with OAB, the urgency will result in urge UI. The other major type of incontinence is stress UI, caused by a loss of urethral sphincter function. Although these symptoms occur about half as often in men as in women, they are a source of considerable bother and frustration when they are present. A thorough history, physical examination, and urinalysis are sufficient to guide initial therapy. Men with complicated symptoms (concomitant pain or hematuria, recurrent infections, poor bladder emptying, severe symptoms, prior pelvic radiation, neurologic disease, or major pelvic surgery) should be referred for specialized management. Behavioral therapies such as dietary modification, bladder training, and pelvic muscle exercises may be beneficial for symptoms of OAB, urge UI, and stress UI. Antimuscarinic medications are commonly used to treat OAB and urge UI. For refractory symptoms, sacral nerve stimulation is an effective surgical option. Stress UI in men is typically caused by prior prostate surgery. The most common treatments for male stress UI are transurethral injections of bulking agents, placement of a perineal sling, and implantation of an artificial urinary sphincter. External (condom) catheters and penile clamps are useful adjunctive measures for UI, which may be applicable for certain men.

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Authors and Affiliations

  1. Department of Urology, University of Michigan Medical Center, 1500 East Medical Center Drive, Taubman Center 3875, Ann Arbor, MI, 48109, USA

    Humphrey Atiemo MD & J. Quentin Clemens MD, FACS, MSCI

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  1. Humphrey Atiemo MD
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  2. J. Quentin Clemens MD, FACS, MSCI
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Correspondence to J. Quentin Clemens MD, FACS, MSCI .

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  1. The Glickman Urologic and, Kidney Institute, Department of Urology, Cleveland, 44195, Ohio, USA

    Daniel A. Shoskes

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Atiemo, H., Clemens, J.Q. (2012). Managing Overactive Bladder and Urinary Incontinence in the Male. In: Shoskes, D. (eds) Urological Men’s Health. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-900-6_13

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  • DOI: https://doi.org/10.1007/978-1-61779-900-6_13

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