Male bladder control problems: a guide to assessment

Overactive bladder is a common health problem that affects millions of men and women. Despite its prevalence, provider knowledge is lacking with regard to evaluation and treatment modalities. Although bladder control problems are less common in men than in women, the burden of incontinence may be more significant. In men presenting with symptoms of urgency and frequency, a differential diagnosis between overactive bladder and benign prostatic disease must be made because their cause and treatment are different. Empiric treatment of urgency symptoms may cause them to worsen if the diagnosis is not correct. Symptom assessment should include a medical history, physical examination, urinalysis, and post void residual study. Over the past several years, many new medications have become available to treat both overactive bladder and benign prostatic disease. These medications, in combination with behavioral interventions, are safe and effective. The evaluation and treatment of men with symptoms of overactive bladder and/or incontinence is discussed.