Incontinence medicine

Incontinence medication can be an important piece of the puzzle if you are experiencing urinary retention problems. In this article, I’ll give you an overview of the types of medications available, how they work and what to look out for in terms of effectiveness, side effects and your everyday life. I’ll walk you through how we can find the right solution together to give you more control, better sleep and greater freedom – often in combination with exercise and habit change. You’ll get concrete advice to give you peace of mind and peace of mind in your everyday life, and you’ll gain insight into how I can help you achieve your goals safely and purposefully. Read on and discover your options for controlling urination and regaining your quality of life.

Incontinence medication helps by calming bladder agitation, reducing leakage and giving you better control – especially when combined with exercise and individualized interventions.

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Michael Strøm

International speaker & expert in shockwave and EMTT treatment for erectile dysfunction, peyronies & CPPPS.

Incontinence medication for men: What works, what you should consider – and how I help you get there safely

What is urinary incontinence in men?

Urinary incontinence is involuntary urination or difficulty retaining urine. It affects many men – often silently – and at all ages. For some, it’s small leaks after physical activity or when standing up. For others, it’s sudden, strong urges to urinate (urge), frequent night-time trips to the toilet or after-dripping. It’s not a character trait or a matter of willpower – it’s a bodily signal that can be treated. Incontinence medication can be part of the solution, but the best effect is achieved when I help you find the right cause and combine treatment wisely to give you the most control with the least discomfort.

Common types of incontinence

  • Urge incontinence (overactive bladder): Sudden, strong urge and leakage before you reach the toilet.
  • Stress incontinence: Leakage when coughing, sneezing, laughing or lifting – especially after prostate surgery.
  • Overflow/overflow incontinence: Weak stream, feeling of incomplete emptying and leakage due to overfilled bladder, often with prostate enlargement.
  • Mixed incontinence: A combination of urgency and stress.
  • After-drip: Small drops after urination due to fluid in the urethra or pelvic floor function.

Typical causes

  • Prostate enlargement (BPH) or narrow bladder outlet.
  • Effects after prostate surgery or radiation therapy.
  • Overactive or overstretched pelvic floor, irritation of the pudendal nerve and chronic pelvic pain (CPPS).
  • Neurological conditions (e.g. diabetes, Parkinson’s, sclerosis) and certain medications.
  • Lifestyle factors such as high coffee/alcohol intake, poor sleep, constipation and stress.

When does incontinence medicine make sense?

Incontinence medication can reduce symptoms and provide control. The effect depends on the type of problem you have. My job is to map out the pattern and help you to the most targeted path – often with a combination of medication, exercise, neuromodulation and habit adjustment. As a rule of thumb, I assess the effect over 4-8 weeks, adjust the dose or remedy if needed, and ensure you have simple strategies in everyday life to complement the medication. The goal is fewer leaks, calmer bladder, better sleep and more energy – without you paying with unnecessary side effects.

Overactive bladder and sudden urges

For overactive bladder, medications that either calm and relax the bladder muscle (antimuscarinics) or stimulate bladder relaxation (beta-3 agonist) work. The result can be fewer trips to the toilet, less urgency and fewer leaks. When chosen and dosed wisely, medication can make a big difference in everyday life. I often combine it with bladder training (timed urination), urge suppression (calm breathing, relaxation and short-term postponement of toilet visits) and fluid/caffeine adjustment. Most people notice effects after a few weeks, and full effect may take a little longer. I’ll help you fine-tune so that the benefits outweigh any side effects.

Prostate-related symptoms (BPH)

When urinary problems are caused by an enlarged prostate, alpha-blockers can relax the bladder neck and improve the stream, while 5-alpha reductase inhibitors can shrink the prostate over time. Some men have more storage symptoms (frequent urges) and combination therapy may be relevant. If you have both weak stream, after-drips and nocturnal interruptions, I’ll adjust the strategy to maximize flow with minimal impact on sexuality. The conversation is also about realistic expectations: Alpha-blockers typically work quickly, while prostate-shrinking drugs build effect gradually over months.

Stress incontinence after surgery

After prostate surgery, the sphincter can be challenged. Here, pelvic floor training is the first choice. Some men may benefit from medication such as duloxetine in selected cases, but the evidence in men is limited and side effects must be carefully weighed. Often, targeted rehabilitation and neuromodulation is a better start. I teach you precise pelvic floor activation and timing, the use of breathing to stabilize abdominal pressure, and small everyday adjustments to reduce leakage when coughing, sneezing and lifting. Many people experience gradual improvement over weeks to months as the technique becomes ingrained.

Nocturia and nighttime urination

Some are due to overactive bladder or prostate, while others are “nocturnal polyuria” – the body simply makes too much urine at night. In some cases, desmopressin can be used, but safety is key (risk of low blood sodium). I guide you on when it’s relevant to discuss this option with your doctor and how to manage fluid intake in the evening (often less after late afternoon) and practical sleep routines for longer uninterrupted sleep. At the same time, I rule out obvious causes such as late caffeine intake, disrupted circadian rhythm or fluid retention in the legs during the day.

Overflow and urinary retention

If the bladder does not empty, medications that relax the bladder should be avoided as they can make the problem worse. In this case, the first step is to ensure good emptying – e.g. via alpha-blockers, bladder emptying techniques such as “double voiding” (peeing twice with a short break) or temporary catheterization after medical assessment. I am aware of signs such as frequent urgency, weak stream and persistent pressure in the lower abdomen, and I recommend appropriate medical evaluation for suspected narrow urethral passage or significant residual urine.

Types of Incontinence medications – pros and cons

Here’s an overview at eye level. What they do, who typically benefits and what you should be aware of.

Antimuscarins (e.g. solifenacin, tolterodine, fesoterodine, darifenacin, oxybutynin)

  • Works by cushioning the bladder muscle and reducing urgency and frequency.
  • Beneficial for overactive bladder and urge incontinence.
  • Common side effects: Dry mouth, constipation, blurred vision. In the elderly, cognitive side effects may occur.
  • Use with caution when at risk of urinary retention.
  • Practical advice: Sugar-free gum/chewing gum/tablets can relieve dry mouth and fiber/fluid aid prevents constipation. If confusion or severe fatigue reappears, treatment should be reassessed.

Beta-3 agonist (mirabegron)

  • Helps the bladder relax, increases capacity and reduces urgency.
  • Often better tolerated than antimuscarins. Can be combined with them for extra effect.
  • Possible side effects: Slight increase in blood pressure, palpitations. Interacts with certain medicines.
  • Practicalities: I typically recommend measuring blood pressure at the start and when changing doses and checking for drug interactions with your doctor or pharmacist.

Alpha-blockers (e.g. tamsulosin, alfuzosin, silodosin)

  • Relaxes the bladder neck and prostate for better flow and less voiding.
  • Good for BPH-related symptoms and overflow.
  • Side effects: Dizziness, drop in blood pressure, nasal congestion, ejaculation disorders.
  • Tip: Start often in the evening to reduce dizziness and pay attention when changing positions. If you experience difficulty ejaculating, I’ll adjust the plan and alternatives.

5-alpha reductase inhibitors (finasteride, dutasteride)

  • Reduces prostate size over months and reduces the risk of acute urinary retention.
  • Best for moderate to large prostate. The effect builds gradually.
  • Side effects: Decreased libido, erectile dysfunction, reduced sperm volume. PSA drop around 50% (important when interpreting blood tests).
  • Alignment of expectations: I explain the timeline for efficacy and how PSA values are adjusted in the interpretation so you and your doctor don’t misunderstand the result.

Tadalafil in low dose (daily 5 mg)

  • May improve urinary symptoms in BPH while helping with erectile dysfunction.
  • Good choice if you have both LUTS (Lower Urinary Tract Symptoms) and erectile dysfunction.
  • Side effects: Headache, flushing, acid reflux, back pain. Do not combine with nitrate preparations.
  • Bonus: Can increase quality of life by addressing two issues at once. I clarify contraindications and realistic goals before you talk to your doctor about a prescription.

Desmopressin (for nocturnal polyuria)

  • Reduces urine output at night so you can sleep longer between toilet visits.
  • Relevant for documented nocturnal polyuria – not routine for anyone with nocturia.
  • Important: Risk of low sodium (hyponatremia), especially in the elderly. Requires attention to fluid intake and often blood test monitoring via your GP.
  • Practical: Typically, limited fluids are recommended from one hour before to 8 hours after the dose. I’ll go through warning signs and routines so you use the product safely.

Duloxetine (selected cases of stress incontinence)

  • May increase sphincter tone. Used more in women; in men often limited and selective use, e.g. after surgery.
  • Side effects: Nausea, sleep disturbances, fatigue. Tapering may be necessary.
  • Usage: I only use it where the potential benefits clearly outweigh the disadvantages – and always with a follow-up plan.

Infections, stones or inflammation can cause transient incontinence-like symptoms. Here, targeted treatment of the cause (e.g. antibiotics for urinary tract infections) is the important first step. I’ll guide you on what signs to look out for, such as burning, fever, blood in the urine or sudden worsening – and when to contact your GP urgently.

Incontinence medication and sexual function

If you also have erectile dysfunction

Many men with urinary symptoms also have erectile dysfunction. Low-dose tadalafil can be a strong option here because it addresses both. Conversely, some BPH medications can cause sexual side effects. I’ll go through the pros and cons with you so you don’t trade one problem for another, and I’ll help you come up with a plan that addresses performance, desire and intimacy in your sex life.

Peyronie’s disease and pelvic pain

Penile curvature and chronic pelvic pain can affect bladder control indirectly through tension and nerve stress. Medication does not correct curvature, but in my experience, when we calm the pain and pelvic floor, urgency and frequency often decrease. I use neuromodulation and targeted techniques to relax muscles so you can hold and empty your bladder more easily. I also work with pain sensitivity (how the nervous system reacts to stress and strain) so that the body can “release” unnecessary tension.

Is medication always the solution?

No – but it can be an important piece. The best effect is achieved when I combine wisely based on the cause. That’s the strength of my approach: a balanced plan where medication is used when it makes sense and exercise, neuromodulation and habit change do the rest of the work.

Advanced diagnostics with me

  • Thorough medical history: Patterns, trigger situations, circadian rhythms and fluid habits.
  • Objective assessment of pelvic floor function and nerve impingement.
  • Ultrasound scan as part of the overall assessment, for example if prostate-related problems are suspected or to gain better insight into tissues and structures in the pelvis.
  • Symptom and fluid chart: Handy tool for targeting interventions.

Combination therapy: focused sound waves, EMTT and neuromodulation

  • Neuromodulation: Gentle stimulation of nerves (e.g. tibialis stimulation) can reduce overactive bladder and urgency and strengthen the bladder control network.
  • Focused sound waves (shockwave): Used especially for chronic pelvic pain. Can increase blood flow, loosen sore muscles and reduce pain so that the pelvic floor works more appropriately. It can indirectly improve urination.
  • EMTT (electromagnetic transduction therapy): Can relieve pain and tension in the pelvic floor and support tissue healing in addition.

Supplemented with targeted pelvic floor training (both strength and relaxation), breathing techniques, sleep and habit coaching, many achieve the best lasting effect – with or without Incontinence medication. I follow your response closely and adjust the intervention to suit your goals and your everyday life.

Training, lifestyle and habits that work

  • Proper pelvic floor training and cough/sneeze timing.
  • Relaxation if the pelvic floor is overactive (very common in CPPS).
  • Adjusting caffeine, alcohol and fluid timing.
  • Prevent constipation and pressure on the pelvic floor.
  • Sleep hygiene – especially if nighttime symptoms are prevalent.
  • Bladder training with regular visits to the toilet and urge suppression between visits so that the bladder can hold more without agitation.

How I help you – step by step

First consultation

I get straight to the point – respectfully and without taboo. You tell me where the shoe pinches: leakage, urgency, after-drip, pain, erection, sleep. I screen for red flags and probable causes. I assess whether incontinence medication makes sense and what else should be prioritized first. You leave with specific exercises and a plan for the next steps.

Plan and follow-up

I create a simple, realistic plan: what actions, in what order and how we measure progress. If necessary, I may recommend that you talk to your GP about prescription medication, relevant blood tests (e.g. sodium for desmopressin), PSA or other tests that are not performed in the clinic. You get concrete tools from day one, and I follow up so that you experience steady progress – not random fluctuations.

Course in Copenhagen – men from all over Zealand and Denmark are welcome

The clinic is located in Copenhagen and I have men from all over Zealand and the rest of the country. You’ll be met with a professional but down-to-earth approach where you are at the center – whether the problem is new or has been going on for years. There’s room for questions and you get answers that can be used in everyday life.

Frequently asked questions about Incontinence medication

Is medication the first thing I should try?

Not always. For overactive bladder, behavioral strategies, neuromodulation and exercise can be just as important – and sometimes enough on their own. For prostate-related symptoms, medication can be an obvious first choice. I’ll help you with the sequence and create a plan that takes into account both efficacy and side effects.

What if I’m afraid of side effects?

It’s healthy skepticism. I go through the pros and cons – also in relation to your everyday life, work and sexuality. Often there are alternatives or lower dose combinations that work better. I teach you little tricks to manage common side effects and we agree on clear stopping or switching criteria.

Can Incontinence medication make erectile dysfunction worse?

Some drugs can affect libido, ejaculation or erection. Others – like tadalafil – can improve both. That’s why I customize recommendations to your specific situation, so you don’t solve one problem by creating another.

Mirabegron or antimuscarins – which is better?

It depends on your symptoms and tolerance. Mirabegron is often better tolerated, while antimuscarins can be very effective – and the combination can be strong. I’ll help you choose what’s most effective with the least discomfort, and I’ll follow up so we can adjust quickly if needed.

Does desmopressin help with nighttime urination?

Yes, if the cause is nocturnal overproduction of urine. This requires careful consideration and often blood test control via your own doctor. Otherwise, I focus on bladder, habits and sleep – typically with very good effect.

What if I have pelvic pain and incontinence at the same time?

It is very common. Overactive pelvic floor and nervous stress can drive urgency. Many people experience improvement when I combine neuromodulation, relaxation and, if relevant, focused sound waves or EMTT – possibly supplemented with medication. The goal is to down-regulate the alarm signals in the nervous system so that the bladder calms down.

Is there anything I can do right away?

  • Keep a short fluid and urination schedule for 3 days.
  • Cut down on caffeine/alcohol and hydrate earlier in the day.
  • Practice calm, deep breathing and abdominal/pelvic relaxation.
  • Learn “pinch at the right second” with cough/sniff and drip techniques.
  • Contact me for a targeted plan – saving you time and frustration.

What about tests and scans?

I use relevant clinical examinations and ultrasound as part of the assessment. If further tests or blood tests are needed, I will guide you on how to discuss this with your GP. My goal is to determine the exact cause so that you get the right treatment in the right sequence.

My approach: professionalism, calm and results

I work daily with men who struggle with urination, erection, pelvic pain or concerns about their sex life. With me, there are no raised eyebrows – just a clear plan, respect and reassurance. Incontinence medication can be a powerful tool, but rarely the whole answer. When I hit the right cause and combine wisely, the lasting improvement occurs: fewer leaks, less anxiety, better sleep, more energy – and often a stronger sex life.

Next steps – calm urination and more energy

If you want a solution that fits your everyday life and your goals, book an appointment with me in Copenhagen. I help men from all over Zealand and the rest of Denmark. Together we’ll find out if Incontinence medicine should be part of your program – and what other measures will make the biggest difference for you. It’s not taboo with me. It’s common sense and concrete action.

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.

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Are you in doubt? Get clarity on your options

I will get back to you within 12-24 hours.

Get a no-obligation clarifying conversation today

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.