Behavioral therapies for urinary incontinence in men

Treatment Overview

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Several types of behavioral methods are used for treating urinary incontinence: bladder training, habit training, biofeedback, and pelvic muscle exercises. Men who have incontinence due to physical or mental limitations (functional incontinence) can try timed voiding and prompted voiding.

Bladder training

Bladder training (also called bladder retraining) is used to treat urge incontinence. Bladder training attempts to increase how long you can wait before having to urinate. A health professional will teach a person about the structure of the lower urinary tract and the causes of incontinence.

A voiding schedule is first established. Then you are trained to resist the first urge to urinate and refrain from urinating until the scheduled time. The intervals between scheduled bathroom visits are increased until you can refrain from urinating for several hours.

Biofeedback

Biofeedback is a technique for learning to control a body function that is not normally under conscious control, such as skin temperature, muscle tension, heart rate, or blood pressure.

Men with incontinence are taught bladder-sphincter biofeedback methods along with pelvic floor exercises. These techniques record bladder, rectal sphincter, and abdominal pressures as well as electrical activity. As the information is recorded, it is displayed for you. By watching the information, you learn to relax your bladder and abdominal muscles and contract your pelvic floor muscles based on the information displayed.

Learning biofeedback requires practice in a lab or other setting under the guidance of a trained therapist. Home biofeedback units also are available.

Timed voiding

Timed voiding is also called habit training. It is used to treat urge incontinence. It sets a schedule for urinating (voiding) that is determined by your personal habits and does not attempt to increase how long you can wait before having to urinate or to teach you to resist the urge to urinate.

Prompted voiding

Prompted voiding requires a caregiver to prompt the incontinent person to urinate. The goal is to decrease the chance of accidents by making the person aware of the need to urinate periodically. Prompted voiding usually is used in combination with timed voiding for people who are unaware of their bodily functions, such as people who have dementia.

What To Expect After Treatment

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See the How Well It Works section below.

Why It Is Done

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Behavioral methods may be used to treat urge incontinence.

How Well It Works

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Bladder training

• The initial response rates to bladder training are moderate.
• Most people who use bladder training have fewer symptoms of incontinence. Some people completely eliminate their incontinence.

Biofeedback

Biofeedback has been successful in treating men who have urge incontinence following removal of their prostate gland.

Timed voiding

Timed voiding reduced the frequency of incontinence accidents in the majority of the people who used this method.

Prompted voiding

People who use prompted voiding generally have 1 to 2 fewer incontinence accidents per day.

Risks

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There are no risks associated with this treatment.

What To Think About

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Behavioral methods require a high level of motivation.

Prompted voiding requires a committed caregiver to be successful.

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

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Other Works Consulted

• Carlson KV, Nitti VW (2001). Prevention and management of incontinence following radical prostatectomy. Urologic Clinics of North America, 28(3): 595–612.

• Ouslander JG (2004). Urinary incontinence. In L Goldman, D Ausiello, eds., Cecil Textbook of Medicine, 22nd ed., vol. 1, pp. 111–114. Philadelphia: Saunders.

• Payne CK (2002). Urinary incontinence: Nonsurgical management. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 2, pp. 1069–1091. Philadelphia: W.B. Saunders.

Credits

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Author	Ralph Poore
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	Avery L. Seifert, MD - Urology
Last Updated	August 10, 2006