When the National Association for Continence (NAFC) released data showing that 65% of men with incontinence report reduced self-esteem, men's health coach Derek Calloway wasn't surprised. He'd lived that statistic. At 54, after a prostatectomy left him managing daily leaks, he spent nearly two years shrinking his world β€” canceling gym sessions, skipping work trips, and quietly stepping back from the social life he'd spent decades building. What pulled him out wasn't just therapy or willpower. It was a combination of hard-won mindset shifts, practical solutions, and the decision to stop letting a medical condition define his identity.

Today, Derek coaches men across the country who are navigating incontinence after prostate surgery, diabetes-related bladder changes, and age-related pelvic floor weakening. His approach is unapologetically practical: less "talk about your feelings," more "here's what you're going to do differently starting Monday." We sat down with Derek to talk about rebuilding confidence, dismantling shame, and the specific strategies that actually move the needle for men living with incontinence.

The Wall Every Man Hits First

Derek remembers the exact moment the isolation set in. It was a Sunday morning, about six weeks post-surgery, when he soaked through his clothing during a walk to the mailbox. "I just turned around, went back inside, and didn't leave again for three days," he says. "Not because I was in pain. Because I was humiliated."

That experience β€” the retreat, the shame spiral, the quiet contraction of life β€” is something he now sees in almost every client who comes to him. According to the NAFC, bladder conditions affect more than 25 million Americans, yet men are significantly less likely than women to seek treatment or even discuss symptoms openly. The reasons are predictable: masculinity norms, fear of judgment, and the deeply held belief that incontinence is something that happens to "old men" or people who've "given up."

"The first wall every guy hits is the wall of silence," Derek says. "He's not telling his doctor. He's not telling his wife. He's definitely not telling his buddies at the gym. And the problem with silence is that it lets your brain fill in the worst-case story β€” that you're broken, that it's permanent, that your life is over as you knew it."

For men in the early stages of managing light leaks or post-exertion drips, Derek often recommends starting with a product switch as a concrete, immediate confidence booster. "I tell guys β€” stop wearing something that makes you feel like a patient. Start wearing something that lets you move like yourself." He's seen men make immediate behavioral changes simply by switching to Orykas light leaks boxer briefs, which look and feel like regular underwear while providing discreet protection. "When you don't feel like you're wearing a diaper, you stop acting like you're wearing a diaper," he says bluntly.

Mindset Shift #1: Stop Catastrophizing, Start Problem-Solving

Derek's first major intervention with clients isn't emotional β€” it's cognitive. He uses a framework borrowed from cognitive behavioral therapy (CBT), which has strong evidence behind it for health-related anxiety, to help men separate the fact of incontinence from the story they've layered on top of it.

"The fact is: you have some level of bladder leakage. That's a medical condition, like high blood pressure or a bad knee. The story is: I am less of a man, I can't do the things I used to do, everyone will notice, my relationship is ruined. I make guys write those two things down separately. Because once you see them side by side, you realize how much energy you're spending on the story."

Research from the NIH supports this approach β€” men who catastrophize urinary symptoms report significantly worse quality of life than men with objectively similar symptom severity but lower anxiety scores. The condition itself matters, but so does the mental framework around it.

Derek's practical prescription: spend 10 minutes a day actively problem-solving rather than ruminating. What's the one activity you've stopped doing that you miss most? What's the single barrier that's actually stopping you? Nine times out of ten, he says, there's a concrete solution β€” a scheduled bathroom break, a route planned near restrooms, the right protective underwear β€” that removes the barrier entirely.

Mindset Shift #2: Redefine Control

"Men associate confidence with control," Derek explains. "And incontinence feels like the ultimate loss of control. So the work becomes redefining where your control actually lives."

He walks clients through what he calls the "Control Inventory" β€” a structured list of everything within their power: pelvic floor exercises (which the American Urological Association confirms can significantly reduce leakage in men with post-prostatectomy incontinence), dietary adjustments like reducing caffeine and alcohol, timing fluid intake, and choosing protective gear that matches their actual lifestyle and absorption needs.

For men managing moderate leakage or recovering from surgery, Derek points toward products designed for heavier protection without sacrificing dignity. "I had one client who was avoiding overnight visits with his grandkids because he was terrified of leaking through the night," Derek recalls. "We got him set up with Orykas absorbent boxer briefs and a washable bed pad for the guest room, and he was there for Christmas three months later. That's not a small thing. That's his life back."

The reframe, Derek insists, is powerful: "You can't always control what your bladder does. But you can control your preparation, your protection, and your participation in your own life."

Mindset Shift #3: Identity Before Diagnosis

One of the most consistent patterns Derek sees in clients is what he calls "diagnosis capture" β€” the point where a man's entire identity begins to organize around his condition. He stops being Derek who coaches football on weekends and starts being "the guy with the bladder problem."

"I always ask my clients: who were you before this diagnosis? What did you care about? What made you feel capable and alive? And then I ask: how many of those things are actually gone, versus how many have you just stopped doing because you're scared?"

Most of the time, the answer is sobering. The golf game is still accessible. The camping trip is still possible. The gym is still there. According to the Mayo Clinic, lifestyle modifications combined with the right protective products allow the vast majority of men to maintain active, engaged lives while managing incontinence. The barrier is usually psychological, not physical.

For men who want to try protection across different styles before committing, Derek often recommends exploring Orykas value packs as a low-stakes way to find what fits their body and lifestyle best. "Confidence comes from preparation," he says. "And preparation starts with having the right gear for whatever you're actually doing."

Life Today: What Recovery Actually Looks Like

Four years out from his surgery, Derek's incontinence has improved significantly β€” a combination of pelvic floor therapy, medication adjustments, and time. But he's quick to point out that his confidence returned long before the leakage resolved. "I stopped waiting for my bladder to give me permission to live my life," he says. "That was the real turning point."

He still coaches men in all stages β€” some freshly post-surgery, some years into managing chronic symptoms, some finally addressing leakage they've silently tolerated for a decade. The commonality, he says, is the moment when a man decides to stop hiding and start adapting. "Hiding takes everything from you. Adapting gives you your life back β€” usually better, honestly, because you've had to get honest with yourself about what actually matters."

His final message to men reading this? "Get the right information. Get the right support. Get the right underwear. In that order, or any order β€” just start somewhere. Because the cost of waiting is your actual life, and nobody gets that time back."

Frequently Asked Questions

1. Is it normal for men to feel embarrassed about incontinence?

Absolutely, and it's extremely common. The NAFC reports that 65% of men with incontinence experience reduced self-esteem, and many wait years before discussing symptoms with a doctor. The embarrassment is understandable, but it shouldn't be a barrier to getting help. Speaking with a urologist or pelvic floor specialist is a practical, judgment-free first step β€” and most men report significant improvement once they seek treatment.

2. What are the most effective ways to build confidence while managing male incontinence?

According to men's health coaches and clinicians, the most effective strategies combine practical preparation with mindset work. This includes: pelvic floor exercises (confirmed by the AUA to reduce post-prostatectomy leakage), scheduled voiding routines, dietary adjustments (reducing caffeine and alcohol), using protective underwear that feels normal to wear, and cognitive techniques like CBT to address shame and anxiety. Confidence tends to rebuild faster when men focus on what they can control.

3. How do I choose the right incontinence underwear as a man?

It depends on your level of leakage. For light drips or stress incontinence during exercise, Orykas light leaks boxer briefs offer discreet protection in a style that looks like regular underwear. For moderate to heavy leakage, post-surgical recovery, or overnight use, Orykas absorbent boxer briefs provide higher absorbency without bulk. If you prefer a briefs cut, Orykas incontinence briefs are also available. Washable, reusable options are more sustainable and cost-effective than disposables over time.

4. Can incontinence in men improve over time?

Yes β€” significantly, in many cases. The Mayo Clinic notes that post-prostatectomy incontinence often improves substantially within the first year, particularly with consistent pelvic floor rehabilitation. For men with overactive bladder or stress incontinence related to other causes, behavioral interventions, medication, and in some cases minimally invasive procedures can dramatically reduce symptoms. Early intervention typically leads to better outcomes, so seeking evaluation sooner is always better than waiting.

5. How do I talk to my doctor about incontinence without feeling embarrassed?

Remember that urologists and primary care physicians discuss incontinence every single day β€” it's one of the most common conditions they manage in men over 50. A simple, direct opening works well: "I've been experiencing some bladder leakage and I'd like to talk about my options." You don't need to minimize it or apologize for bringing it up. Bringing notes about your symptoms β€” frequency, triggers, severity β€” helps your doctor assess your situation quickly and get you to the right treatment plan faster. The conversation is almost always less uncomfortable than men expect it to be.

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