Sexual Dysfunction & Male Incontinence


Sexual Dysfunction & Male Incontinence

Sexual Dysfunction & Male Incontinence

Sexual dysfunction and male incontinence are common problems for men. It is estimated that over 30 percent of men experience sexual dysfunction while almost 20 percent have incontinence issues. Many effective treatment options exist to help you find relief from these problems, so you should never hesitate to talk to your physician about issues you are experiencing.

Sexual Dysfunction

Erectile dysfunction (inability to achieve an erection) is one of the most common male sexual problems. It may result from a variety of causes, including:

  • Aging
  • Diabetes
  • Coronary artery disease
  • Hyperlipidemia (high cholesterol)
  • Medicines for other conditions
  • Perineal trauma (injury to the area between the scrotum and the anus)
  • Cancer treatment

Less common sexual dysfunctions are premature ejaculation and lack of libido (desire to have sex). Premature ejaculation may be embarrassing and interfere with sexual intimacy. Lack of libido may interfere with intimacy as well. Fortunately, treatment for these conditions is effective in many cases.

Male Incontinence

The inability to control urination may result in embarrassment and interfere with a man’s ability or willingness to go out in public. Men with this condition may be anxious about wetting themselves in public or smelling like urine.

There are two major types of incontinence: stress incontinence and urge incontinence.

  • Stress incontinence. Release of urine when coughing, lifting and doing other activities that stress the pelvis is called stress incontinence. This often results from problems with the sphincter (muscle encircling the urethra, which is the tube that carries urine out of the body). Pelvic surgery and neurologic conditions are two common causes of this difficulty.
  • Urge incontinence. The sudden urge to urinate may result in discharge of urine because the man cannot reach a bathroom in time. Disease and irritation of the bladder, infection and nervous system disorders are common causes for this problem.

Sexual dysfunction and male incontinence may often be treated successfully. Indiana University Health urological specialists have extensive experience accurately diagnosing and treating men’s sexual and urinary difficulties. We use a variety of techniques to help many men recover sexual ability and control urinary problems.

We recognize that difficulties like these may cause emotional stress. Our patient-centered approach to your sexual or urinary condition takes your feelings into account. We involve you in developing your treatment plan and respect your needs and preferences.

We have a wide array of options for treating sexual and urinary problems. This assures you that the care you receive from IU Health urologists provide the best possibility for you to overcome your condition and enjoy a better quality of life.

Our ongoing research into new treatments for incontinence demonstrates our commitment to helping men recover from this condition. We have ongoing clinical studies of incontinence outcomes and research into congenital urinary conditions. Artificial sphincters (muscles encircling the urethra, the tube that carries urine out of the body) are another area of our research. Our treatment of sexual dysfunction with penile implants (a treatment for erectile dysfunction) is nationally regarded.

How We Can Help

Sexual Dysfunction & Male Incontinence Treatment Information

Sexual dysfunction and incontinence have a variety of causes. Their effects are relatively minor for some men but may be severe for others. Treatments vary to suit the cause and degree of your condition.

Sexual Dysfunction

A variety of treatments are available to overcome erectile dysfunction, including:

  1. Medicine. A wide variety of medications tend to cause erectile dysfunction. If you are taking any of these drugs, your physician may substitute a different medicine without this side effect. There are also several medicines that aid erection. Viagra, Levitra and Cialis are among these. Erectile dysfunction medicines help blood flow to the penis, enabling it to become erect. Changing or adding medicines allows many men to regain erectile function.
  2. Appliances. A vacuum pump may be used to draw blood into the penis by lowering pressure around the penis. When the penis is erect, a constricting strap is placed around the base to prevent blood from flowing out of the penis. This maintains the erection.
  3. Penile implants. The penis contains two chambers that swell with blood to create an erection. When neither medicines nor appliances work to gain an erection, inflatable tubes may be placed in these chambers. When the tubes are inflated, the penis becomes erect. Deflating them returns the penis to its flaccid state.

Premature ejaculation may often be resolved with relaxation and other techniques. Sometimes relaxation exercises or thinking about something other than sex may provide the necessary delay. When this is not enough, medicines called selective serotonin reuptake inhibitors (SSRIs) may solve the problem. SSRIs are generally prescribed as antidepressants, however a possible side effect of these medicines is delayed orgasm.

Sometimes a man may have low libido (desire to have sex). This may happen for a variety of reasons. Various life stressors may reduce libido. Psychotherapy to help deal with these stressors may help regain interest in sex. Some drugs reduce libido. Medicines to lower blood pressure and SSRIs prescribed for depression may have this side effect. Your physician may prescribe different medicines that have less effect on libido.

Male Incontinence

Men with incontinence often use absorbent pads to soak up urine. The number of pads you use each day is a factor in choosing an appropriate treatment. If you are using a small number of pads, it may be best to continue using them. The more pads you use each day, the more important it may be to receive treatment for your incontinence. We help you understand your options so you can make the right decision for you.

Sometimes a history of your urinary problem is enough for diagnosis. In other cases, we may need to perform urodynamic testing. This procedure uses electrodes that allow us to monitor the bladder, urine flow and volume of leakage during the test. We can often determine the best treatment options using this information.

Treatments we may use include:

  1. Strengthening exercises. If the cause of incontinence is weakness of the sphincter, and nerves and blood vessels are not damaged, exercises to strengthen the muscle may control urination. This method, called Kegel exercises, is simple and can be performed many times a day. The effect is not immediate, but over time you may regain urinary control without further treatment.
  2. Condom catheter. This slips over the penis and is secured at the base of the penis. A tube at the end of the catheter is connected to a bag that collects urine. The bag may be strapped to one leg, allowing some freedom of movement. A larger bag hung by the bed may be used at night. This method is generally used with men who are not very active.  
  3. Penile clamp. This is a specially designed device that compresses the penis, constricting the urethra. When the clamp is released, urine flows freely. A penile clamp should be carefully fitted to provide the right amount of urethral constriction without damaging the penis. A clamp should be released regularly to allow full blood flow to the penis and prevent damage to the skin and other tissues of the penis.
  4. Male sling. The male sling is a piece of mesh implanted around the urethra to help hold back urine. The sling may be anchored to bone and works by compressing the urethra enough to regain urinary continence. The sling may also be anchored to muscles in the pelvis. This method works by repositioning the urethra to regain continence. The sling is appropriate for men who have some urinary control before the procedure.   
  5. Artificial sphincter. A ring placed around the urethra is connected to a bulb beneath the skin of the abdomen. Using the bulb, you inflate the ring, which compresses the urethra to stop urine flow. To urinate you deflate the device, which allows free urine flow. This is a very durable treatment that lasts for a decade or longer. It can be replaced when needed.
  6. Medicines. If your incontinence is caused by uncontrollable urges to urinate, there are medicines that may reduce these urges. Some of these block nerve impulses that signal the bladder to contract. Drugs to slow the production of urine may also be effective in reducing urge incontinence. Some medications relax the bladder or shrink the prostate. Both of these actions reduce bladder spasms and relieve urge incontinence.

Some men have incontinence because of a combination of bladder and sphincter problems. We may combine treatments to provide the degree of control you need.

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