Dr. Sanjay Gogoi
Men generally care more about their cars, phones and gadgets than their bodies. Lack of awareness and inadequate education about health and poor work-life balance has led to a rapid decline in men’s health all over the world. Men over the age of 50 are beginning to experience a number of health problems, of which stress urinary incontinence (SUI) is a lesser known problem.
According to international studies, 3 to 5 percent of men and 11 to 34 percent of elderly men are affected by SUI. However, lack of awareness of this problem can have a profound impact on patients’ lives, leading to depression and loss of will to live.
Stress incontinence is rare in men, but it affects a person’s social and professional life. In general this is an iatrogenic condition. Cases are likely to increase in the future as the number of prostate surgeries is increasing in the world population.
Symptoms
One of the most common symptoms of SUI is leaking urine when doing any activity that puts pressure on the abdomen. Urine leaks even with normal activities, such as changing sides, sitting up, walking, coughing, etc.
The amount of leaking urine can range from a few drops to a lot. SUI affects a person’s daily and social activities. This can also affect the interpersonal relationships of the person. Often people feel embarrassed about this problem and isolate themselves from the society.
cause
The main cause of SUI in men is a weakened or damaged urethral sphincter. Common surgeries for prostate enlargement such as TURP, laser prostatectomy have reduced surgical morbidity. However, post-operative SUI lasting more than 6 months is seen in 0.5 percent to 0.4 percent of cases.
Surgical procedures for prostate cancer, such as open radical prostatectomy and robotic prostatectomy, can damage the bladder neck, and cause urethral hypermobility. SUI occurs in about 7 to 10 percent of cases. Other causes of this are pelvic trauma, which damages the pelvic surface.
remedy
After recognizing these symptoms and signs, a doctor can be consulted for the treatment and management of SUI. Based on the individual’s medical condition, the doctor advises the best course of treatment for the patient.
In many cases, a penile clamp or clip device is used to stop the SUI leak. These external clamps stop the flow of urine from the penis. However, they cause many inconveniences and problems.
Surgery may be recommended for some patients for the prevention of SUI. One of the most effective treatments for male SUI is the implantation of an artificial urinary sphincter. This device has three parts:
Fluid-filled cuff that is placed around the urethra (the ureter leading to the bladder to carry urine out of the body). A fluid-filled, pressure-controlled balloon that is placed in the abdomen. In the scrotum A pump is fitted and the device is controlled by this.
This device is filled with fluid, which keeps the urethra closed and prevents leakage. When the patient presses the pump, the fluid in the phlegm is pushed inside the balloon and the urethra opens up, allowing the person to urinate. Artificial sphincter surgery helps control urination for most men with SUI.
Another surgical option is called a male sling, which helps control mild to moderate urinary incontinence by repositioning the urethra. Treating urinary incontinence improves quality of life. Surgical treatments are quite effective along with lifestyle modifications. Due to the stigma associated with this problem and the small number of patients, it is necessary to increase the awareness of urinary incontinence that almost all cases of this development are treatable.
(The author is Senior Consultant & Head, Urology & Renal Transplant at Manipal Hospitals, Dwarka, New Delhi)