Christian Seipp MD PhD
Consultant Urological Surgeon
Leakage that occurs during walking, coughing, sneezing and physical exercise is usually the result of damage to the sphincter, the muscle that closes off the urethra. Damage to the closing mechanism of the bladder can be caused by prostate cancer treatments (e.g. radical prostatectomy or radiation therapy), pelvic trauma or surgery (e.g. prostate operations for benign disease). In rare cases stress leakage can be the result of diabetes, multiple sclerosis, Parkinson's disease or stroke.
It is important to distinguish stress urinary incontinence from other types of urinary leakage such as urge incontinence (leakage accompanied by an overwhelming need to urinate = overactive bladder), mixed incontinence (leakage associated with both exertion and urgency) and overflow incontinence (leakage due to incomplete bladder emptying).
Controlled fluid intake and pelvic floor exercises under the supervision of a physiotherapist can often provide significant relief. Non-surgical treatment comprises of absorbent products such as pads or diapers to contain the involuntary leakage as well as external penile clamps or catheters.
In cases where urinary incontinence persists despite intensive pelvic floor exercises over at least three months you may benefit from surgery in an attempt to restore normal continence: the current gold-standard in male incontinence surgery is the artificial urinary sphincter. Alternatively, male patients can opt for sling surgery to improve urinary control.
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