Urinary incontinence is common especially as we get older. It is not a disease but a symptom of involuntary release of urine. Over 13 million Americans experience incontinence with two times more women than men being affected. Often, people suffer silently because they are too embarrassed to seek help from a health professional.
Struggling with an ongoing incontinence may cause a decline in the individual’s psychological and physical well-being. Depression, irritability, sleep deprivation, and avoidance of social interaction may result.
For assistance with this column, I interviewed Dr. Marelyn Medina, a McAllen-based practicing adult and pediatric urologist. This will be a three part series divided into male, female and pediatric incontinence. The following information is based on my interview with Dr. Medina concerning male incontinence.
Part I: In the male population incontinence can arise from anatomical defects as well as chemical contributors. An anatomical disorder generally involves the following four organs in men: the kidneys, bladder, prostate and urethra. The bladder stores urine made in the kidneys and the prostate produces semen fluids that are part of ejaculation. The prostate lies at the base of the bladder exit, surrounding it like a doughnut. The urethra is the long channel that runs through the penis, allowing urine in the bladder to leave the body during voiding. An abnormality in any of these four essential organs will result in loss of urine control.
Anatomical disturbances can occur in several fashions. When there is infection in any of the four organs, marked irritation in the thin lining of the conduit surfaces, called the mucosa can initiate premature lose of urine. Acute infections occur suddenly and with symptoms of incontinence, burning on urination and possibly blood in the urine. There may also be pain in the pubic area. Chronic infections my have the same but less intense symptoms. Both types of infections have been traditionally treated with antibiotics medications. Unfortunately, the chronic infections are more resistant to treatment and generally require several changes in antibiotics.
Another anatomic abnormality that often results in loss of urine control in the male patient has to do with a blockage of the urine outflow. This can occur at the base of the bladder or the urethra. In both cases there is excessive accumulation of urine in the bladder. As a result the bladder is never fully emptied. As a consequence, the bladder’s nerve supply starts working overtime and occasionally causes contractions at inappropriate times
In men, the bladder can become blocked when stones have settled inside of it. Enlargements of the prostate, as well as scar tissue in the urethra from old infections, are more common reasons for a blockage of the urinary tract. The urologist can determine the presence of these abnormalities by performing ultrasound and CT scan studies. It will also be necessary to undergo direct visualization of the urethra, prostate and bladder by directing a telescope through the urethral channel. This is called a cystoscopy.
Chemical contributors to urinary incontinence are related to medications or dietary substances. Diuretic medications are those that increase the volume of urine produced by the kidneys. They are usually given to patients in an attempt to control high blood pressure or to remove fluids accumulating in the body, in particular in the legs or lungs. Caffeine and chocolate can also act as diuretics and predispose a man to incontinence.
Dr. Medina stated that treatment of symptoms, without a thorough understanding of all the contributing factors involved with a patient’s incontinence can at times make a bad situation even worse. Obstruction of the urinary tract, if not addressed properly, can lead to bladder damage and permanent injury to the kidney from back pressure.
She also stressed that patients must be on guard not to be swayed by the glossy advertisements with the press or television concerning incontinence drugs. Many of these medications have serious adverse effects that may affect other organs such as the heart and eyes. Instead, seek the advice of a urologist for treatment options.
Urinary incontinence is not normal and can be improved or cured in the majority of cases by seeking professional care. Next week’s column will include Part II — Women Incontinence and Part III — Child Incontinence will follow. For a consultation, Dr. Marelyn Medina can be reached at The Family Urology Center in McAllen at (956) 686-7243.
Mary Garza Cummings is a free-lance writer. The Town Crier does not warrant the information as valid. It is the responsibility of the reader to ensure validity of the information. For comments, email firstname.lastname@example.org