Incontinence is the involuntary release of urine.

It’s common in men following prostate surgery as their urinary sphincter has been surgically traumatised and may be weakened.  So when they cough, sneeze or move suddenly the internal pressure within the bladder can exceed the closure pressure of the sphincter and urine exits the body.  This is called stress urinary incontinence and can be treated effectively with pelvic floor exercises to develop sphincter strength over time.

For some however the picture of incontinence is different;  they may have never had a prostate issue.  Instead they develop an overwhelming urge to urinate.  When this occurs regularly they start to develop a behavioural pattern of urinating all the time (frequency).  This can result in the bladder never being stretched and like any muscle it gets less compliant and less able to store large volumes.  A vicious cycle then develops where the bladder volume gets smaller (less able to store for as long)…the sphincter working overtime to try to stem the urge can become tight and weakened…and the sufferer tends to wee ‘just in case’ to prevent incontinence episodes…The cycle can peak with the sphincter unable to cope as the bladder starts to pre contract and the urge itself causes leaking (usually on the way to the toilet).

The solution for urgency and frequency issues is a little more complex than just pelvic floor muscle strengthening.  It may involve relaxed breathing exercises, fluid balance changes, utilising deferral strategies and even neural stimulation techniques, so its important to be well assessed prior to commencing rehabilitation.  For some people with frequency issues pelvic floor muscle strength training makes things worse.

Whichever way you look at things, incontinence is a major issue that needs urgent and specific attention.  So don’t put off getting assessed, man up and get it checked.