This guide is for information only. It does not replace advice from a doctor. If your leakage is recent, getting worse, or comes with pain, fever or blood in the urine, see a doctor promptly.
A common problem that is still taboo
Urinary incontinence means any involuntary loss of urine, even a few drops. In men, the subject is still rarely discussed: many wait months before mentioning it to their doctor and make do with absorbent pads. Yet there are solutions suited to every situation, and the first step is to identify the type of leakage correctly.
The different types of leakage
Stress urinary incontinence
Leakage happens when pressure in the abdomen rises suddenly: coughing, sneezing, laughing, lifting something, standing up from a seated position, running or jumping. There is no urge to pass urine before the leak. It is a sign that the sphincter, the muscle that closes off the bladder, no longer holds firmly enough.
Urge incontinence
Here, the leak follows a sudden, pressing urge that is hard to hold back. It is often referred to as an overactive bladder. The causes and treatments are different from those of stress incontinence.
Mixed incontinence
This combines the two: leakage on exertion and sudden urges.
Overflow incontinence
The bladder does not empty properly, for example because the prostate is obstructing the flow, and urine dribbles out drop by drop. This situation needs prompt medical advice.
Why stress incontinence occurs in men
- After prostate surgery. Prostatectomy, particularly for cancer, is the best-known cause. The operation weakens the sphincter. Leakage often decreases over the following months, but it can persist. See our article Urinary incontinence after prostatectomy.
- After radiotherapy to the pelvic area.
- With age, as the pelvic floor muscles lose their tone.
- With certain intensive sports that put heavy strain on the pelvic floor (running, jumping, weightlifting).
- With a neurological condition, such as a spinal cord injury, which affects control of the bladder and sphincter.
Leaking at night, dribbling after passing urine: other situations
Leaking at night
Waking up wet does not have the same causes as stress leakage: you are lying down and pressure in the abdomen is low. Night-time leakage can be linked to an overactive bladder, a bladder that does not empty properly or producing a lot of urine at night. It calls for medical advice. A penile clamp must never be worn at night.
Dribbling after passing urine
A few drops escaping just after you leave the toilet is known as after-dribble, or post-micturition dribble. A little urine stays in the urethra and then leaks out. It is common, especially with age, and different from stress incontinence. Mention it to your doctor, especially if it is recent or comes with difficulty passing urine.
Possible solutions
See a doctor and take stock
Your GP or a urologist can determine the type of leakage and its cause. This diagnosis points the way to the right solution.
Pelvic floor rehabilitation
With a physiotherapist, pelvic floor rehabilitation strengthens the muscles that support the bladder and the sphincter. It is often offered as the first-line treatment, especially after a prostatectomy.
Absorbent pads
Pant liners, pads or absorbent underwear collect the urine. They are easy to use but have their limits: ongoing cost, bulk under clothing, dampness against the skin and fear of odours.
Penile sheaths
A silicone sheath connected to a bag collects the urine. Sheaths are mainly intended for heavy or continuous leakage.
Penile clamps
A penile clamp applies pressure to the urethra to close it during exertion. It does not collect urine: it holds it back. It is a suitable solution for light to moderate stress leakage, in men who have good skin sensation. It is worn during the day, removed to pass urine and not worn at night. To compare models, readHow to choose a penile clamp.
Medication
Medicines for urinary leakage mainly act on an overactive bladder, that is, on sudden urges. For stress leakage, treatment relies above all on rehabilitation, devices and, if needed, surgery. Only a doctor can prescribe the right treatment: do not take any medicine without medical advice.
Surgical treatments
When leakage remains heavy despite rehabilitation, the urologist may suggest surgery, such as fitting a male sling (suburethral tape) or an artificial urinary sphincter.
Where SEAL fits in
SEAL is a soft silicone penile clamp designed for moderate stress leakage (level 1 to 2). It can replace or reduce the use of pads during the day, during rehabilitation or afterwards. It is not suitable in cases of urge incontinence, overactive bladder, impaired skin sensation or cognitive impairment.
To find out how to fit it and which precautions to follow, see the instructions for use.
In summary
- Leakage on exertion, without a sudden urge, points to a weak sphincter.
- Talk to your doctor to confirm the type of leakage and its cause.
- Pelvic floor rehabilitation is often the first step.
- Depending on how heavy the leakage is: pads, a penile clamp, a sheath or surgery.