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Depression Linked to Urinary Incontinence in Men

Posted Jun 11 2010 6:59am

Nearly 5% of American Men Suffer From Urinary Incontinence , A recent study had found.

Major depression, hypertension, enlarged prostates, and older age are all associated with an increased risk of moderate to severe urinary incontinence (UI) in men, a large study suggests.

The findings, which provide one of the first snapshots of urinary incontinence in men , may help improve doctors’ ability to identify men who are suffering from the condition, says study head Alayne Markland, of the University of Alabama at Birmingham.

Overall, 4.5% of American men were found to experience moderate to severe urinary incontinence, which corresponds to having leakage at least once a month, the study showed.

The rate increases with age, from 0.7% in men ages 20 to 34 to 16% in men age 75 and older, the study showed.

The findings were presented at the annual meeting of the American Urological Association.

Studies suggested that urinary incontinence is less common among men than women , but there was felt to be a lack of data on Urinary Incontinence and risk factors in men, Dr. Markland felt.

So she and colleagues analyzed data from 5,297 men aged 20 and older who participated in the National Health and Nutrition Examination Survey, a nationally representative survey of the U.S. population.

Men were interviewed in their homes, and Urinary Incontinence was assessed using the 12-point Incontinence Severity Index in which participants are asked if they leak and if so, how much and how often. Moderate to severe Urinary Incontinence was defined as a score of 3 or higher.

Among all the men, major depression and hypertension were associated with a 2.6-fold and a 30% increased risk of moderate to severe UI, respectively.

Each 10-year increase in age was associated with an 80% increased risk.

Among the 3,010 men aged 40 and older, enlarged prostate — called benign prostatic hyperplasia (BPH) — was associated with a 20% greater chance of having moderate to severe UI.

The rate of moderate to severe Urinary Incontinence did not differ by race or ethnicity.

A total of 49% of the men had what is known as urge urinary incontinence, in which you feel like you have to go but can’t get to the bathroom in time, Dr. Markland said. Thirteen percent had stress urinary incontinence, which occurs when an activity, such as coughing or sneezing, causes a small amount of urine to leak. The rest had a combination.
BPH a Known Cause of Urinary Incontinence

BPH is a well-known cause of UI, says Ira Sharlip, MD, clinical professor of urology at the University of California, San Francisco.

“Nightly bathroom runs may be the first sign of an enlarged prostate, other symptoms may include trouble starting a stream of urine, leaking, or dribbling” says Dr. Sharlip, who was not involved with the study.

That’s because an can press against the urethra (the tube that carries urine out the body) and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.

More research is needed to find out why depression and hypertension are associated with higher rates of UI, Dr. Markland said.

Medications called diuretics that are often used to treat may play a role, she says. They flush excess fluid from the body and can cause frequent urination.

Some of the drugs used to treat depression may also cause UI, Sharlip says.

“Urinary incontinence is something people don’t want to talk about,” says Lauren P. Wallner, PhD, MPH, a research fellow in the department of urology at the University of Michigan in Ann Arbor.

“If you’re having symptoms, bring it to the attention of your Doctor or Health professional as it can often be treated with medication, behavioral therapy and, in severe cases, surgery,” she said.

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