Kegels and Male Incontinence / Leakage

Kegels and Male Incontinence / Leakage

Bladder control issues are a spectrum, from true urinary incontinence on one side to “occasionally leaking a few drops” on the other end. But regardless of the details, they are at a minimum annoying, and at a maximum life-changing in the limitations they enforce on your lifestyle and activities. Imagine the possibility of crossing off all the activities in your life that don’t have ready bathroom access, and it’s easy to see why these issues are worth staying on top of (or ideally, getting out in front of).

Furthermore, you might not know it (because many men find them embarrassing and are thus reluctant to talk about it), but they are quite common. This study found that amongst men over 40, nearly half of men experience some degree of leakage regularly.

Put those two things together (this happens to a lot of guys, and it can really impact your lifestyle when it does) and it’s clear that this is a topic worthy of attention. This article looks at the main approaches that men use to deal with incontinence / bladder control struggles, with a particular focus on Kegels (since, despite many guys thinking of them more in the context of women’s health, they are commonly recommended by doctors and pelvic floor physical therapists for men working on bladder control too).

 

What Solutions Are Out There?

Unsurprisingly, considering how common the problem is, there are a number of approaches out there. We’ll look at some of the most popular, with a separate section devoted to Kegels at the end.

 

Pads

Pads can help with leakage but don't address the underlying issue

Pads can be helpful but are best used in combination with efforts to address the root problem.

Pads are perhaps the easiest solution – they’re basically an absorbent strip that lives in your underwear and soaks up any leaks. They are then replaced as needed. On the plus side, you can start using them at any time and they should keep your underwear, clothes and body more or less dry throughout activities as needed. However, they’re not attempting to deal with the underlying problem or prevent leakage, just trying to minimize the effects and mask the symptoms. And unfortunately, bladder control is one of those problems in life that tends to get worse over time if you don’t tackle it head-on. Plus, the costs can add up over time. All this means that pads can be a useful tool to manage leaks but are best suited for temporary use, while you’re taking other steps to get at the root cause.

 

Lifestyle Changes

Regular exercise can help improve bladder control

One of the best ways to address leakage more thoroughly, and one of the best places to start (since there are no risks to this approach), is to look at lifestyle changes involving diet, exercise, and habits – these can have a large impact. Here are 5 tips to start with:

  1. Watch what you drink. Reducing or eliminating your intake of caffeine, alcohol and carbonated drinks can all help improve bladder control. And there’s a bit of a Goldilocks situation going on too, where drinking either too much OR too little fluid can be a problem. Staying well hydrated is important, but best to do it by drinking smaller amounts more steadily as opposed to going into camel mode and rarely drinking but guzzling a ton when you do.
  2. Likewise with food. Acidic foods (including highly processed foods and citrus fruits) and spicy foods (sad but true) can both be bladder irritants that can exacerbate leakage problems.
  3. Exercise more. This one can actually be two birds with one stone – exercise in general can reduce incontinence symptoms and if, on top of that, the exercise triggers weight loss, that can help too (separate from the exercise itself). But one word of caution – jumping, running, or other exercise where your body is strongly impacting the ground can be particularly hard on weaker pelvic floor muscles and trigger leakage. So lower impact exercise is a great place to start (it’s easier on your joints, too).
  4. Try double voiding when convenient (go pee, wait a few minutes, then go again – this can help train your body to fully empty the bladder and avoid overflow incontinence).
  5. Avoid constipation: straining during bowel movements is bad for your pelvic floor, which is bad for your bladder control. On the plus side, the exercise, hydration and dietary tips from above should also help with minimizing constipation too.

These lifestyle tips are great and can have a big impact. But lifestyle factors are often not the only cause of (or solution to) bladder control issues. For guys where they don’t help, or who are having more severe problems, there are some stronger weapons in the arsenal too.

 

Medical Avenues

These are basically options you need your doctor for. And as mentioned, it’s better to try more conservative steps first – if those work then that’s great, and you can avoid the below possibilities (all of which have some potential risks / drawbacks):

  1. Medication: there are a number of drugs that can be used to treat urinary incontinence, depending on what flavor of incontinence is present and other factors (too many to list here). But as with all drugs, there are risks around potential side effects and other issues like drug interactions.
  2. Surgery: there are multiple surgical procedures that are sometimes used to treat urinary incontinence that has not improved after other approaches are tried. Probably the most common is a male sling surgery, where material is implanted to reposition the urethra and provide support to the surrounding muscles so they can more effectively keep the urethra closed. The other main surgical option (typically used for quite severe incontinence) is placement of an artificial urinary sphincter, where a fairly complicated hydraulic system is implanted that can open/close the urethra.
  3. Catheter: a thin tube inserted into your bladder (usually via the urethra / penis) that allows your urine to drain out through the catheter into a bag, which is emptied periodically. Catheters are often used during surgical recuperation but can be used longer term in cases of extremely severe incontinence.

Overall, medical approaches have their place but conservative therapies (like lifestyle modifications) are always preferred, and doctors will definitely recommend you explore them before getting into the above possibilities.

 

What About Kegels?

Pelvic floor (or Kegel) exercise is the other main conservative therapy that is definitely worth exploring for any men who have issues with incontinence or bladder control / leakage.

 

How Is The Pelvic Floor Related To Bladder Control? Do Kegels Actually Help?

The pelvic floor muscles are basically the gatekeepers for your bladder and bowel function – they are supposed to relax when you need to pee or poop and then tighten afterward to prevent leakage. (They also have other jobs around sexual function and supporting your pelvic and abdominal organs, but that’s a topic for another day). When they are too weak, that can cause, or exacerbate, problems with bladder control. (It should also be noted that they can also be too tight, or overactive – in this case they may be causing pelvic pain and Kegel exercise is not a good option).

Male pelvic floor anatomy

The pelvic floor (in blue) is a network of muscles, ligaments and other tissues at the base of the pelvis that has a key role in bladder control.

 

Kegels are a standard recommendation for men with pretty much any type of bladder control problem (for instance, see this article from Harvard Medical School).

 

How Do You Do Kegels?

So, Kegels should be (along with the lifestyle changes addressed above) the starting point for any guys with bladder control / leakage issues. Great – how do you do them?

It’s pretty easy, actually. Picture yourself going pee and then think about what muscles you would use to stop the flow of urine (without using your hands). Those muscles you just used are your pelvic floor muscles and you just did, or imagined doing, a Kegel. You can also visualize a squeezing and lifting sensation, and trying to avoid passing gas as you stop the flow of urine.

In fact, Kegels can be a bit too easy for some guys. One of the biggest problems with Kegels is that it’s hard to stay with a consistent exercise routine due to boredom. After all, you’re just sitting there squeezing muscles you can’t even see, then relaxing them, then squeezing, then relaxing… etc etc). For most of us, it’s hard enough to have the self-discipline to stick with an exercise regimen that is actually engaging – if the exercise is boring (and you can’t even see what’s going on), it’s nearly impossible.

IF KEGELS DON’T WORK - CONSIDER PROKEGEL

Kegel exercises require diligence and persistence. If you aren’t seeing results, or are impatient and feel like you need a better, faster alternative, we have had great success with our in-office kegel trainer called PROKEGEL. PROKEGEL is a non-invasive, FDA-approved treatment that tones your bladder and pelvic floor muscles, returning neuromuscular control to the pelvic floor. Emsella uses focused, high-intensity electromagnetic  technology to stimulate the deep muscles of the pelvic floor, causing them to contract. A single  session produces thousands of supramaximal pelvic floor muscle contractions, which serve to re-educate men’s pelvic floor muscles. It produces the same result as doing 10,000 kegel exercises in a half hour. We call it the Kegel Throne.

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