MANY health matters are unfortunately surrounded by stigma, often such that sufferers don't seek treatment until they reach crisis point. One such condition is urinary incontinence.

Several myths abound, for example that is a natural part of ageing, an unfortunate consequence of childbirth, or that it doesn't need to be taken seriously. Perhaps the biggest misconception is that it only happens to women.

Yet with urinary incontinence affecting a quarter of men over the age of forty at some point, and a sub-specialty of urology dedicated to its management, male incontinence most definitely exists and is a topic worthy of discussion.

Urine is produced by the kidneys, passing down the ureters to the bladder, where it is stored. At the base of the bladder is the prostate, a ring-shaped structure, through which the urethra passes, allowing urine to exit at the appropriate point.

Urinary incontinence can be either temporary, for example due to urinary tract infection or constipation, or long term.

Long term causes are a consequence of damage to the nerves controlled in urination, over-activity of the bladder muscle itself, or prostate issues.

Neurological conditions include Parkinson's Disease and Multiple Sclerosis. Incontinence may occur after a stroke or injury to the spinal cord. Diabetes can affect the nerves involved in bladder control.

The detrusor muscle of the bladder may be unstable such that you get a sudden uncontrollable urge to void urine, sometimes so strong that incontinence results.

Benign prostatic enlargement or hypertrophy (BPH) and prostate cancer can both cause urinary incontinence, with very little to differentiate the benign from the sinister, so it makes sense not to dismiss any symptoms. Prostate cancer surgery can result in stress incontinence, though in most cases it is thankfully temporary.

Certain lifestyle choices are linked with an increased risk of urinary incontinence. Consumption of large volumes of alcohol and caffeine are associated with greater frequency of urination and stronger urgency symptoms. Consuming fluids late at night may also disturb sleep by the desire to urinate.

While holding on to urine will result in better bladder control up to a point, excessively pursuing this may result in a situation where you really can’t hold it a moment longer, increased likelihood of urine infections, or a bladder that stretches so much that it can no longer contract properly or empty fully.

Conversely, denying yourself fluids may lead to you becoming dry and the bladder being more irritable.

In both sexes the bladder is supported by the pelvic floor, so any weakness of this as well as excess pressure being put on it by being overweight or obese will also have a negative effect on bladder function.

For anyone with urinary incontinence, the most important message is that it is nothing to be ashamed of. Many sufferers will have become so controlled by their symptoms that they are literally too scared to leave the house, with those who do governed by needing to know the location of every available facility.

Your regular doctor will start by taking a history of the complaint as well as a physical examination.

A rectal examination will assess for constipation and any enlargement of the prostate gland. A urine sample will test for infection and routine blood tests will demonstrate how well the kidneys are functioning. If there is a possibility that you are not emptying your bladder fully, an ultrasound scan can accurately assess the residual volume left in the bladder after you have passed urine.

Treatment is based upon cause, and for those without a serious underlying condition, the benefit of lifestyle measures should not be underestimated. Achieving a sensible weight, bladder retraining, and pelvic floor exercises can produce significant benefits.

You should neither consume excessive volumes of fluid, nor restrict yourself. Ideally most of your fluid intake should be plain water for good general and bladder health.

For bladder instability, if bladder retraining does not produce satisfactory results, tablet medications are first line. Botox injection into the bladder muscle may be offered after assessment in a specialist clinic.

Surgery may be offered for benign prostatic hypertrophy that has not responded to oral medications as well as for prostate cancer. Robotic surgery, one of the most cutting-edge technologies is now available in the field of urology. Yet despite the whole gamut of treatments available less than one in five men with urinary incontinence seeks help.

So, for anyone still reading and affected, help is available. There is no need to suffer in silence.