Incontinence in the elderly is far more common than you might think, affecting your freedom, sleep and confidence. Here’s an overview of the typical causes, symptoms and solutions – from pelvic floor and bladder training to advanced treatment with EMTT and focused sound waves. I’ll walk you through how I thoroughly investigate the problem and put together an individualized course that gives you back control and peace of mind. Read on to understand why incontinence is not something you should just accept and how together we can make tangible improvements – regardless of previous experiences. My treatment gives you realistic hope and a plan that works in practice.
Incontinence in the elderly is involuntary urination that can be caused by several factors – but can almost always be improved with targeted training, habit modification and individual treatment.
International speaker & expert in shockwave and EMTT treatment for erectile dysfunction, peyronies & CPPPS.
Incontinence in the elderly is more common than most people think. If you’re struggling with urine leakage, frequent trips to the toilet or a sudden, strong urge, you’re far from alone – and you can do something about it. I help men who may also suffer from erectile dysfunction, pelvic pain or other intimate challenges to find peace, control and a life without constant worry. My starting point is professionally strong, but down to earth: I take it step by step, identify the cause and build an individual program that makes sense for you. You don’t need to be in top shape to get started – you just need to be curious about change and we’ll find the pace together.
Incontinence in the elderly refers to involuntary urination or leakage. For some, it’s small drips during physical activity. For others, it’s a violent, sudden urge (overactive bladder) that can’t be contained. Both affect sleep, social life, relationships and self-esteem. I meet men without prejudice and without taboo – the goal is concrete recovery and peace of mind. Swedish and international guidelines describe incontinence as a symptom, not a character flaw – and that’s how I treat it: as a problem that can be solved.
Urine leakage, frequent urination, nocturnal awakenings, weak stream, difficulty emptying, feeling of unease in the abdomen, pelvic pain, burning sensations or a constant tightness in the pelvic floor. Many people also find that their erection is affected – it’s not uncommon for the two to be related. If you experience a sudden worsening, fever, burning or blood in the urine, I will guide you to a relevant medical check-up.
Incontinence in older men rarely has a single cause. The right solution starts with understanding what mix of factors are at play in your case. When the puzzle – muscles, nerves, habits, medication and psychological factors – is put together correctly, the plan becomes clear and realistic.
Prostate enlargement (BPH) can cause weak stream, difficulty emptying and overflow incontinence. After prostate surgery (e.g. cancer), the sphincter may be weak, resulting in stress incontinence. Both situations can be improved with targeted training and behavioral strategies, and in some cases medication or surgery, which you can discuss with your doctor. After surgery, I often see a gradual improvement as technique is refined and everyday life is adjusted – for example, “preparatory squats” before coughing and lifting and good voiding routines such as rest, time and possibly double voiding.
The pelvic floor is the body’s “sling” under the bladder. If it’s weak, you can leak under strain. If it’s too tight (hypertonic), it can trigger overactive bladder and cause urgency, pain and frequent urination. The pudendal nerve, which supplies the pelvic floor, can become irritated – for example in chronic pelvic pain (CPPS) – and contribute to pain, urgency and erectile dysfunction. That’s why I often help both strength and relaxation in place – not just “more squeezing”. I use simple, concrete cues: “Pull up and in around the penis and rectum” and “let your stomach be soft when you let go” so you feel the difference between activating and letting go.
Diuretics (“diuretics”), certain antidepressants, high blood pressure medications and sleep medications can increase leakage or urgency. Caffeine, alcohol, artificial sweeteners and spicy foods can irritate the bladder. Constipation puts pressure on the bladder and worsens symptoms. A sharp review of habits and fluid intake is often part of the solution. I often recommend small, measurable adjustments such as collecting the majority of fluids earlier in the day, trying 1-2 cups of coffee instead of more, and talking to your doctor about the timing of diuretics.
Aging processes change connective tissue, nerve conduction and muscle strength. Diabetes, obesity, sleep problems, stress and pain can exacerbate incontinence in the elderly. Many also have an ‘alarm state’ in the body, where anxiety and worry about leakage itself increases the urge. I’ll help you get everything in gear – both body and nervous system – so the signals from the bladder become less violent and more manageable.
Erectile dysfunction and incontinence are often linked via blood vessels, nerves and muscles in the pelvis. Pain in the pelvis can lead to a constantly tense pelvic floor and an overactive bladder. That’s why I look at the whole picture and work in parallel with the areas that affect each other. When the pelvic floor learns to switch between work and rest, many people experience both better control and better function in intimate situations.
I start by understanding your everyday life and symptoms – without taboos, but with a focus on what you want to achieve: fewer accidents, better sleep, more freedom and safety in intimate situations. I give you the space to talk, and I translate my expertise into concrete actions that fit your life.
I map out patterns: how often do you urinate, how much, when do you leak, what do you drink and how is the sleep? A bladder diary over 3-5 days gives a clear picture. I also cover medication, pain, constipation, leg edema (fluid in the legs) and activity level. The diary becomes your starting point to see progress – not a test you can “fail”.
I assess strength, endurance, timing and the ability to relax. Many people find that their “squeeze” primarily activates the stomach or buttocks – or that the muscles don’t release at all. Correct technique is crucial to the outcome. I always go through what the exam entails and I don’t do intimate exams without your explicit consent. You’ll get clear feedback so you can feel the difference right away.
I use ultrasound scanning to visualize pelvic floor function, scar tissue and muscle balance. This makes training more precise and helps us see if you are using the right muscles at the right time. If nerve irritation or complex pain issues are suspected, I include targeted tests in the clinic. The images provide a common understanding and make it easier to stay motivated because you can see what you’re working on.
If there are signs of infection, blood in the urine, severe voiding problems, significant nocturnal urination or systemic diseases, I advise you to talk to your GP about urine tests, blood sugar, PSA (if applicable), medication review and possible assessment of residual urine. This ensures that we don’t miss anything that requires medical or urological treatment. Collaboration between me and your doctor provides the best course of treatment.
I put together a program based on your goals. I often combine training, behavioral strategies and technologies that can modulate pain and nervous system “alarms”. It’s about restoring control and calm in the bladder – and in you. The plan is simple to follow in everyday life, and we adjust it continuously to make it work in practice.
I fine-tune the technique with biofeedback and ultrasound to target the right muscles. For stress incontinence, it’s all about timing and strength. For urge incontinence, I often start by creating relaxation and better coordination before we add strength. The training is measurable, concrete and fits into your everyday life. Typically, you work with short, precise squeezes (1-2 seconds) to respond to coughs/sneezes and longer squeezes (6-10 seconds) for endurance, and equally important is the conscious relaxation after each squeeze. I also teach you “squat before strain” in everyday situations like standing up, lifting or coughing.
You’ll learn to delay urges gradually, use breathing and diversion strategies, plan fluid intake and reduce bladder irritants like coffee and alcohol. Small changes can have big results – especially on nighttime urination and frequent trips. An effective urination strategy is: stop, stand still, do a few calm squeezes, exhale deeply (like blowing dew off a window), wait until the urge drops to a manageable level – and only then walk calmly towards the toilet. If you’re having trouble emptying, simple measures such as resting in the bathroom, supporting your feet, bending over and possibly double-emptying can help.
Neuromodulation uses mild electrical stimulation to affect nerves that control the bladder reflex and pelvic floor tension levels. It can reduce urgency, improve coordination and reduce pain in chronic pelvic pain. I adjust the frequency and location according to your symptoms, for example around the tibial nerve at the ankle or locally in the pelvic area. The treatment is gentle and in some cases can be combined with home exercises to prolong the effect.
EMTT delivers pulsed electromagnetic fields to deeper tissues. The goal is to improve tissue healing, reduce irritation and normalize muscle tone. For men with CPPS and increased tension, EMTT can be a useful complement to exercise and neuromodulation. It is gentle and takes place without direct contact. I use it in a targeted way based on your examination, so you only get what benefits your specific findings.
Focused sound waves can target connective tissue and muscle attachments in the pelvic region when pain and scar tissue maintain an overactive pelvic floor. By loosening tight structures, we can indirectly reduce urgency and make pelvic floor training more effective. I use it selectively where it makes sense based on your examination. The treatment is typically combined with relaxation and gentle movement afterwards.
For chronic pelvic pain, I work with graduated exposure, breathing, positional relaxation and manual therapy so the body goes from “alarm” to “calm”. Less pain often means less urgency and fewer leaks. You’ll learn specific techniques to use at home – such as 4-6 slow breaths where the exhalation is longer than the inhalation – to reduce anxiety and improve control over cravings.
For overactive bladder, antimuscarinic agents or beta-3 agonists (e.g. mirabegron) may be relevant. For prostate-related complaints, alpha-blockers or 5-alpha-reductase inhibitors may be considered. In selected cases, Botox in the bladder or surgery (male sling/artificial sphincter) is given. I will guide you on what to discuss with your doctor and what to look out for in terms of possible side effects.
While I’m taking the long view, discreet pads, uridoms and planned “safety strategies” can provide peace of mind and courage to get back out the door. The goal is to use them as support, not as the end of the line. I’ll help you choose the right products, ensure good fit and skincare – and phase them out again as control increases.
Most people notice changes within 3-6 weeks when the technique is in place and the habits support the bladder. Larger and more stable improvements are often seen over 8-12 weeks. I measure progress in number of leaks, nighttime awakenings, time between toilet visits and your perceived control. Small “relapses” along the way are normal – we use them as learning experiences to refine strategies. There’s no quick fix, but determined effort works – even if you’ve tried before.
Answer. Incontinence in the elderly is common, but not ‘normal’. It can almost always be improved – often significantly – with the right combination of exercise, habits and, if appropriate, medication or aids.
Some experience recovery after surgery or infection, but most need targeted action. The sooner you take action, the better the results.
It helps when it’s right. For stress incontinence, strength and timing are key. For overactive bladder and pain, relaxation and coordination are the first step. Incorrect training can perpetuate the problem – that’s why I guide you precisely, often with ultrasound feedback.
It’s common for it to go hand in hand. When I improve blood flow, muscle balance and nerve control in the pelvis – and calm anxiety and pain – it can benefit both leakage and erection.
Yes, you can. They can irritate the bladder and increase urgency. Small adjustments in timing and quantity often make a big difference – especially in the evening.
I look at fluid intake, salt balance, leg edema (fluid in the legs), medication timing and bladder training. Simple routines like putting your legs up a few hours before bed or wearing compression stockings during the day can help move fluid earlier in the day.
The answer is no. Assistive technology can provide peace of mind in the here and now, but the goal is to reduce the need through treatment and training. Most can scale down significantly.
Exercise and neuromodulation are gentle. Focused sound waves and EMTT are usually well tolerated. I always adapt the intensity and method to your body.
If symptoms come on suddenly, if you see blood in your urine, have a fever, severe pain, severe difficulty voiding or significant weight loss, you should contact your own doctor quickly. Otherwise, feel free to start with me; I’ll guide you if there are any tests you can benefit from seeing your doctor.
I clarify your goals, review symptoms and habits, and perform a functional pelvic floor examination. I often use ultrasound to ensure proper muscle recruitment. You leave with a plan that typically includes 2-3 simple exercises, concrete everyday strategies and a realistic timeline. I agree clear milestones with you so you can feel progress from week to week, and we follow up and adjust so that the efforts work for you – in practice.
Men with incontinence in the elderly who want fewer accidents, better sleep and greater freedom. Especially those who also experience erectile dysfunction, overactive bladder, chronic pelvic pain (CPPS), pudendal nerve irritation or after effects of prostate surgery. I work with men from all over Denmark – especially Copenhagen and Zealand.
You don’t have to live with constant agitation, planning for toilets and fear of leaks. Incontinence in the elderly can be treated purposefully and respectfully. I offer a safe, professional approach that takes into account your entire situation – from muscles and nerves to sleep, habits and sexual well-being. Contact me today for a no-obligation consultation and a plan that’s right for you.
If you are interested in hearing more about how I can help you, you are always welcome to contact me by phone 41 40 08 58 or email michael@msinsight.dk. I’ll get back to you quickly with a customized proposal so we can find the best way forward together.
I will get back to you within 12-24 hours.
Are you unsure what’s behind your symptoms or whether a specialized course of treatment makes sense? Then you can start with a short, confidential assessment. Here we will assess whether your symptoms match what I work with at MS Insight and what the next relevant step might be.
The clarifying conversation is not a full consultation, diagnosis or treatment plan. It’s for those who want a serious assessment of whether it makes sense to proceed with a more thorough examination, ultrasound scan and individual plan.
The clinic is a private clinic offering an alternative treatment setup to the public system with shockwave, EMTT and NESA X for sexual dysfunctions and especially erectile dysfunction, peyronies and pelvic pain.
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