U

rinary incontinence is defined as the involuntary loss of demonstrably objective urine that constitutes a social or hygiene problem for the person who suffers it. It is a frequent problem and an incidence of 5 to 15% is estimated in men older than 60 years, with important implications in the quality of life of the individuals who suffer it.

Different epidemiological studies show that a significant percentage of people who suffer from it (up to 50%) do not show it; it is mistakenly assumed as a situation proper to adulthood. Overall, urinary incontinence is more prevalent in women. Only in the pediatric age, it is more frequent in men, and the incidence is equal for both sexes in the geriatric age, affecting up to 70-80% of the elderly with severe mental deterioration.

The causes of urinary incontinence in men according to age are: nocturnal incontinence in childhood (15-20% of children aged 4-10 years); Bladder hyperreflexia after spinal cord injury in young men and the elderly, where the incidence is significantly higher.

The most frequent causes of incontinence in men are: bladder overactivity (hyperreflexia-instability), iatrogenic sphincter insufficiency (up to 30% of patients who have undergone radical prostatectomy), overflow incontinence, infravesical obstruction, and bladder urinary incontinence. Due to this multicausality and the peculiarity of each patient, the design of the interventions must be individualized. The completion of a care plan with strict follow-up of these patients modifies the evolution of urinary incontinence and its complications.

Anatomically, men are more protected against the possibility of presenting incontinence. There are circumstances and risk factors for urinary incontinence, such as cerebrovascular accidents, dementia, bladder cancer, diabetes, limitation of mobility, faecal impaction, medications and aging, very prevalent pathologies in medical consultations. Incontinent patients suffer more urinary infections and more depression due to loss of self-esteem and isolation, as well as feelings of guilt with reaction from insecurity and apathy. It can affect sleep and rest, mobility, emotional behavior and the activities of playtime.

Treatment

In men with stress incontinence, urge incontinence or incontinence of effort / mixed urgency, initial treatment should include counseling
adequate on the habits of life, physiotherapy, programmed voiding patterns, behavioral therapies and medication.