URINARY INCONTINENCE IN MEN
DOI:
https://doi.org/10.24144/2077-6594.1.1.2022.254650Keywords:
urinary incontinence, men, therapyAbstract
The study analyzes the treatment of male urinary incontinence.
Methods. The article meeting the criteria for inclusion in this appraisal were evaluated and entered into the Synthesis Matrix. The study findings that answered the research question were assessed and grouped into therapies.
Results. The first-line treatment of urgency urinary incontinence involves bladder retraining and behavioural therapy. If these measures fail, anticholinergic therapy can be used. In cases where medical therapy fails, the treatment options include intradetrusor botulinum toxin injections or neuromodulation. First-line treatment for men with stress urinary incontinence is conservative. This involves behavioural therapy and pelvic floor muscle training/pelvic physiotherapy. Behavioural interventions are mostly supportive measures in this setting that mainly involve weight loss for patients with a high BMI. Surgical treatment can be considered if conservative measures fail. Generally, any surgical intervention is postponed for 6–12 months after surgery. Surgical treatment options include peri-urethral bulking agents, urethral slings and artificial urinary sphincters. Artificial sphincter is the gold standard treatment option for post-prostatectomy incontinence, with continence rates after surgery being more than 80%. Mixed urinary incontinence has components of both urgency and stress incontinence. Management first requires the clinician to determine the most bothersome complaint of the patient. It often involves a combination approach by a specialist, as the treatment of one may make the other worse. Continuous urinary incontinence. It may suggest the development of a fistula between the urethra beyond the distal sphincteric mechanism, or a grossly deficient sphincteric mechanism leading to no restriction of flow. Management of this condition involves surgery or continence devices.
Conclusions. Urinary incontinence in men can be debilitating for the individual. The psychosocial impact of the condition can vary and should be assessed before a tailored treatment is planned. Classification of urinary incontinence can help better identify the underlying causes and guide clinical management, although quite often patients present with complex symptoms that do not typically fit into any type of definition.
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