What is overflow incontinence?
Overflow incontinence tends to occur when the bladder, like an overfull hot water bottle, has pressure put on it and the urine is forced out. This can be caused by neurological problems, which affect the bladder's ability to contract fully, or where urine is not able to come out easily due to a blockage and so pressure builds up. Overflow incontinence accounts for approximately 4% of all incontinence cases (Canadianincontinence.ca). In most of these cases, overflow incontinence is caused by an enlarged prostate. Men with enlarged prostates often complain of a urine stream that is very weak, difficulties or hesitation in starting to pass urine then difficulties stopping the dribble. This is known as terminal dribble (or after dribble). These men often leave a large volume of urine in their bladder even after going to the toilet, this may cause feelings of not fully emptying the bladder. Consequently, they need to visit the toilet very frequently. Overflow incontinence presents as a continuous incontinence and without proper treatment the person will be damp all the time. This causes a person to experience social awkwardness, low self-esteem and can lead to loneliness or restricted social behaviour.
Overflow incontinence may affect your night-time rest, by waking you up numerous times overnight with the need to use the toilet. This is known as nocturia. A difficult to empty bladder may also cause bladder or kidney infections, because urine that stays in the bladder for long periods of time offers some bacteria a good environment to grow in.
However, with your doctor’s help and some guidance from Depend you can manage the condition. The following section on overflow incontinence discusses the causes and how to manage it.
What causes overflow incontinence?
Essentially, overflow incontinence is caused when your bladder is filled beyond its normal capability. This generally results in leakage from the bladder, which may occur anytime during the day or night. This over-filling can be caused by two factors. The first, by an outlet blockage usually seen with an enlarged prostate. The second underlying cause might be a weak or absent bladder contraction, caused by damage to the neurological system. Nerve damage may be caused by a variety of ailments including Spinal Cord Injury, Parkinson's, MS or Diabetes.
Certain medications – especially Anti-depressants, Anticholinergic agents, Calcium channel blockers, Antipsychotics and Opioids are all known to affect a person’s bladder contractions.
Whatever the cause, overflow incontinence occurs when the bladder over-fills and urine leaks out under pressure.
Overflow incontinence treatmentThe most important aspect of this type of incontinence is a correct diagnosis. A common test done by doctors and continence nurses is an ultra sound of your bladder. Your urine may also be analyzed to check for bladder infections or kidney stones. Often treatment depends on the diagnosis of the underlying cause. For example, if it’s a medication that’s causing your incontinence, treatment may be as simple as changing your current medication to another type of medication that does not affect the bladder contractions but still addresses your needs. When the root cause is not known or you simply want to lessen the severity of the syndrome, the following treatments are recommended:
- Bladder Scheduling: This entails going to the bathroom at certain times during the day so that your bladder never overfills.
- Double voiding: A few minutes after you first empty your bladder, try again to empty the remaining volume. Some people find getting up to wash their hands after the first void and then returning to the toilet a good practice technique.
- Pelvic Floor Exercises As mentioned above, bladder contraction weakness is a common cause of overflow incontinence. Pelvic floor exercises can strengthen the surrounding muscles and strengthen your ability to hold on till you get to the toilet.
- Incontinence surgery: Surgery is one of many options your doctors may offer you when your overflow is caused by an enlarged prostate that blocks your urine flow. Incontinence following this type of surgery is common but for most men it often resolves in about 12 months. The most important things to do during this recovery period is to do Pelvic floor exercises
- Incontinence medication: A group of medications called alpha-blockers have been found to be effective in reducing the symptoms of overflow incontinence. These medications work by relaxing the portion of your urinary tract allowing your urine to flow out more easily. Your doctor is the best person to talk to about the appropriateness of starting this type of medication.
- Intermittent self-catheterization: is another commonly used management technique, especially for those people with a bladder that does not contract well because of neurological problems. Your Urologist or Continence Nurse Advisor are the best people to talk to about this option. They will be able to teach you how to self-catheterize and what products you should buy.
- Products: Depend® has a great range of disposable absorbent products that will help you feeling clean and dry. These incontinence products are designed to minimize the embarrassment and stress that incontinence can cause.