Urinary incontinence – the unintentional leakage of urine – is often seen as a women’s issue, but many men also experience it.

• 5% of men under 45 have urinary incontinence.
• 10–20% of men over 75 are affected. After age 65, stress incontinence becomes less common, while urgency and mixed urinary incontinence becomes more frequent.

Types of Urinary Incontinence in Men

Urgency Incontinence

This is the most common type in men. You may feel a sudden urge and rush to the toilet (urgency), and perhaps leak on the way (urgency incontinence). It is often worse in cold weather or when you hear running water (this is also true in women). Dribbling after urination is also common.

Often linked to benign prostatic hyperplasia (BPH) – enlargement of the prostate.

Lifelong Bladder Problems

Some men have had urinary issues since childhood – such as bedwetting, urgency, or  frequent urination.

Stress Incontinence

This occurs when urine leaks during physical activity, coughing, or standing. It can happen after prostate surgery, such as prostatectomy. While common after surgery, it typically improves over time.

Why Prostate Enlargement Causes Urinary Issues

As men age, the prostate gland often enlarges:

• 40% of men aged 60 have an enlarged prostate
• 75% of men aged 80 are affected

This condition – BPH – is a non-cancerous condition. A normal prostate is about the size of a walnut and weighs 20–25 g, but it can grow to 60 g or more. As it enlarges, the prostate wraps around the neck of the bladder like a collar, narrowing the outlet. This makes it harder for urine to pass, so the bladder muscle must work harder to empty the bladder.

Effects of BPH

• Poor urine stream or difficulty starting/stopping urination, urine flow stops and starts.
• Frequent urination  in small amounts, including getting up at night to urinate.
• Incomplete bladder emptying, which can lead to overflow incontinence — a constant dribbling of urine due to an overly full bladder.

What You Can Do

Do You Have Signs of Prostate Enlargement?

You might if you:

• Struggle to start urinating
• Take a long time to urinate
• Stop and start during urination
• Dribble after you think you’re done
• Feel your bladder isn’t emptying completely
• Get up more than twice a night to urinate, with small amounts

If you answer yes to any of these, consult your doctor or health care provider.

If Urgency Is Your Main Symptom

You can try bladder retraining. Medications may also help calm an overactive bladder — speak to your doctor.

Post-Urination Dribbling

Try milking the urethra: Run your finger from the base to the tip of the penis to expel any remaining urine.

Bedwetting in Adulthood

If you have always had bladder problems, including wetting the bed at night (nocturnal enuresis or bedwetting), this may suggest a lifelong bladder dysfunction. Consult your doctor or healthcare provider.

What Your Doctor Can Do

For Prostate-Related Symptoms 

• Medications such as
  • Finasteride — shrinks the prostate, but regrows if you stop taking it.
  • Alpha-blockers — relax the bladder neck and the prostate itself.
• Surgery may be necessary if symptoms are severe.

After Prostate Surgery

If incontinence persists after a few weeks:

• Try pelvic floor muscle exercises, ideally taught by a trained clinician (physiotherapist or nurse)
• In some cases, surgical procedures may help:
  • Urethral sling to support the urethra (tube from the bladder)
  • Artificial urinary sphincter (AUS) to restore control

Artificial Urinary Sphincter (AUS)

This surgically implanted device includes:

• A fluid-filled cuff around the urethra
• A control pump in the scrotum
• A reservoir in the abdomen

To urinate, press the pump to release the cuff. After a few minutes, the cuff refills to prevent leakage.

• Success rates: 70–80% of men experience improvement
• Complications: 30–45% may need device revision within 10 years (BJU Int 2011;107(suppl 3):7–10)

First published on embarrassingproblems.com
Reviewed and edited by Dr Diane K. Newman
Last updated: July 2025 by Dr Diane K. Newman