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Why would a young man experience urinary incontinence?

For about a year and a half, I have been experiencing slight urine leakage after using the bathroom. Sometimes it occurs minutes after, sometimes well over two hours later. I have tried many of the common remedies such as waiting for a few seconds after voiding, "milking" the urethra, and kegel exercises. I believe it would be categorized as stress incontinence as it happens most often when I sit down or stand up, run up the steps, or during running. It appears that the leakage is actually worsening. I would say it amounts to maybe a 1-2 inch wet spot in my underwear. I have started wearing pads for the past few months. I do not drink or smoke. What would be the next steps in diagnosing and treating this problem? Should I make an appointment with an urologist or start with my primary care physician? Also, what tests would be used to help diagnose what is causing this? Thanks.
Since you haven't talked with any physician about this problem yet, you can probably start with just your regular primary care physician. They can perform the initial evaluation and help determine if you need any additional workup or referral to a specialist, such as a urologist. Urinary incontinence in a young man is very unusual, in the absence of complicating or prior medical problems. Examples of medical problems which might explain and lead to urinary incontinence include things like a history of trauma to the spine or spinal bifida. For these reasons, make sure to mention to your doctor any relevant past medical history. Also make sure to mention if you have any other concerning symptoms such as trouble emptying your bowels or numbness or weakness in your legs or groin, as these are other symptoms that might indicate a serious problem with the spinal cord as the cause of your incontinence. In the absence of these red flags, it is likely that your doctor will want to start by ruling out sexually transmitted infections or urine infections with some basic lab tests. They'll also want to examine your genitals and prostate for any evidence of inflammation as a cause of the urinary leakage. Based on what they find, they'll be able to make recommendations for treatment. Book an appointment as soon as you can.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
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