Urinary incontinence causes can cover a range of issues, but the result is the same: urine leakage. The cause of each type of urinary incontinence is different. Understanding urinary incontinence causes is important because it can help your doctor and you decide on the best course of treatment for incontinence. First, however, it is helpful to understand healthy bladder function, or urinary continence.
The kidneys produce urine, which is transported to and stored in the bladder. When you urinate, urine travels through a tube (urethra) that runs from the bladder through the prostate and penis to the outside of the body. The urethra has a ring of muscles around it called the urinary sphincter, which regulates the flow of urine out of the bladder. As your bladder fills with urine, the nerves send messages to the sphincter, telling it to stay shut until you are ready to urinate.
When you have to urinate, the nerves send messages to the muscle in the bladder walls (detrusor muscle), telling it to squeeze (contract). This motion forces urine into the urethra, which relaxes and allows urine to pass out of the body.
Urinary incontinence can occur when something malfunctions along this process. The type of malfunction determines what type of urinary incontinence you may experience. In addition, there are other urinary incontinence causes, and in some cases, the cause is unknown.
- Stress incontinence can be caused by prostate cancer surgery (removal of the prostate) or any resulting injury or damage to the sphincter muscle or nerves. Obesity is another cause or contributing factor in stress incontinence. Stress incontinence is the most common type of urinary incontinence men experience after prostate surgery, radiation for prostate cancer, or TURP for BPH.
- Urge incontinence/overactive bladder can be caused by the bladder muscle contracting at inappropriate times, regardless of how much urine is in the bladder. It also can occur if the bladder muscle contracts so hard the sphincter is incapable of holding back the urine. The bladder muscle can be affected by a nervous system condition, such as stroke, spinal cord injury, dementia, diabetic neuropathy, or multiple sclerosis. Other conditions or situations not related to a nervous system disorder that can cause urge incontinence/overactive bladder include urinary tract infection, BPH, prostatectomy (that involved nerve damage), radiation, kidney or bladder stones, or use of certain medications such as diuretics or hypnotics.
- Overflow incontinence can be caused by weakened bladder muscles or a blocked urethra, which can be associated with BPH or a narrow urethra. Other causes of overflow incontinence include nerve damage, a vitamin B12 deficiency, or use of certain medications such as antidepressants, calcium channel blockers, antihistamines, beta-blockers, and hypnotics.
- Total incontinence is caused by failure of the sphincter muscle to control urine flow.
- Functional incontinence can be the result of a physical or mental limitation, such as severe arthritis, paralysis from a stroke, or confusion that prevents a man from reaching a toilet in time to void.
Regardless of a man’s urinary incontinence causes, identifying it is the first step toward resolving urinary leakage.