What Causes Male Incontinence at Night?

Surprisingly, around 4 million men in the UK have some form of bladder problem. As male incontinence is rarely spoken of, this could be even higher.

Male incontinence at night can be frustrating and embarrassing, even costing you your favourite bedding. Although it is difficult, understanding the causes and how to manage it can be very beneficial.

So, What Causes Male Bed Wetting?

Male night time incontinence, often known as Nocturnal Enuresis, can be caused by diseases, genetics and other health problems. The most common causes of male incontinence at night are the following:

• An enlarged prostate gland. When the prostate becomes enlarged it begins to squeeze the urethra, causing difficulty passing urine. As your bladder has difficulty doing this, it doesn’t empty completely, meaning it takes shorter time for it to fill up again. Additionally, due to the extra hard work of the bladder muscles, the bladder’s muscular wall can become less flexible and overactive. In addition to causing urge incontinence, this can also often occur at night time.
• Prostate cancer. Prostate cancer affects your body’s ability to store and hold urine. Prostate cancer treatment can also cause incontinence, due to nerve damage, irritation, inflammation and bladder and muscle damage. As the bladder has more time to fill up at night time, night time incontinence is very common.
• Neurological disorders such as Multiple Sclerosis and Parkinson’s Disease. Neurological diseases can affect the communication between the bladder and the brain and spine. In men with neurological conditions, the brain may not send signals to the bladder to hold on until the morning. Neurological injury due to accidents is equally as common.
• Believe it or not, night time incontinence can actually be genetic. If your family has a history of bedwetting at a certain age, you are much likely to develop night time incontinence.
• An imbalance of ADH Hormone. Some men will produce more urine at night due to a lack of ADH hormone, which prevents your body producing as much urine at night.

The Statistics and Facts

• Urge incontinence is the most commonly reported type of male incontinence, accounting for 80% of male incontinence cases
• There could be an 11% overall prevalence rate of incontinence in the male population
• Stress incontinence accounts for less than 10% of incontinence in males
• Prostate surgery or neurological injury are the most common reasons for male night time incontinence
• The prevalence of incontinence in men of all ages is lower than that of women

Finding the Cause

If you are a male experiencing bed wetting, it is vital to determine the cause of your bed wetting. One of the first places to look for causes of urinary incontinence is whether there’s a family history of bed wetting. A Doctor will likely carry out one of the following tests:

• A physical examination
• Ultrasound of the bladder and kidneys
• Urine test
• Urological examination

You should also keep a track of:

• When your accidents are likely to occur
• Amount of urine voided
• Patterns of fluid
• Dry nights vs wet nights
• Your urine stream when going to the bathroom

Male Night Time Incontinence Treatment and Tips

There are many things that can be done to treat male incontinence at night. Firstly, you can be given a drug called Desmopressin if you have insufficient levels of ADH hormone. This dramatically slows down night time urinary incontinence. You can also ask your Doctor about drugs available to calm an irritated bladder.

If you have night time incontinence due to Prostate Cancer or a Neurological injury, you need to visit a Doctor or specialist to determine whether you need surgery. Surgery options are constantly improving and offer minimally invasive treatment, so don’t be scared about asking for this.

The following management tips can also help:

• Practice double voiding before night time. This sounds obvious, but urinating before night time decreases the risk of having an accident during the night. Double voiding means emptying your bladder once before getting ready for bed, then again right after your usual bedtime routine.
• Set a Bedwetting Alarm. You can purchase bedwetting alarms, which are created to sense any liquid when you urinate. These will wake you up so you can reach the toilet and finish urinating, preventing too much leakage. This is also a good way to retrain your bladder.
• Cut out caffeine. You can read about the impact of caffeine on incontinence here
• Do Pelvic floor Exercises. Kegel exercises can trigger a reflex mechanism and make you more aware of your pelvic area. You can read how to do pelvic floor exercises here.

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