life at...70 something and beyond
Men
AND INCONTINENCE
By Gary Lefkowitz, M.D.
Urinary incontinence (UI) is defined as the involuntary loss of urine. It is a significant problem that greatly impacts one’s quality of life.
Incontinence is prevalent, but is half as common in men as in women.
This remains true even for men in their 70’s and 80’s. Urge incontinence is leakage accompanied by or preceded by urgency to urinate. Stress incontinence is loss of urine associated with sneezing, coughing or exertion. Unconscious incontinence is leakage that is not associated with stress or urge.
Older men are more susceptible to incontinence due to a variety of factors. There are certain conditions common in older men that may also cause urinary incontinence. Prostate enlargement obstructs the bladder and can cause incontinence associated with urge. Those men who have had prior procedures for prostate cancer are also at increased risk of developing incontinence.
Certain bladder conditions, including small lesions in the bladder, can also lead to urinary symptoms including incontinence. Neurologic disease is not uncommon in men in this age group and also can be the underlying cause of incontinence.
Individuals who experience the new onset of incontinence should be evaluated by a physician to discuss therapy. Treatment depends on the cause, but medical therapy is often helpful. Medications to reduce symptoms from an enlarged prostate are commonly used. In addition, medicines that relax the bladder are very effective. Behavior modification is also an important adjunct in the treatment of incontinence.
Surgical treatments most commonly involve procedures to treat an obstructing prostate. Other procedures may focus on reducing incontinence after prostate cancer surgery.
Incontinence may indicate underlying medical conditions that warrant workup and treatment and therefore should be evaluated. In addition, older men with incontinence may not be adequately emptying their bladder. Not treating this condition may lead to bladder and kidney dysfunction.
Older men are more susceptible to incontinence due to a variety of factors
FACING
INCONTINENCE
Less than half of patients who have urinary incontinence report the condition to their doctor. Patients are often unaware of the nature of their condition or are too embarrassed to seek help for it.
In many cases, patients simply feel that incontinence is part of the aging process and do not want to bother their physicians. And, in spite of the common nature of this problem, two-thirds of physicians never ask their older patients if they experience incontinence
In one survey, many physicians claimed they did not have the time to treat the condition. Many also have no knowledge of treatments and did not realize that therapies are available that can help many patients with incontinence.
Incontinence is an important issue to be discussed for both the patient and the physician.
–Lefkowitz
Gary Lefkowitz, M.D., is a urological surgeon experienced in treating diseases of the urinary organs in females and the urinary tract in males. He practices in East Meadow and Freeport.
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