Overflow incontinence

About 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 nervous problems, such as the brain not knowing that the bladder is full, or where urine is not able to come out easily due to a blockage and so pressure builds up. Overflow incontinence accounts for approximately 10-15% of all incontinence cases. In a majority of these cases, overflow incontinence can cause awkwardness, low self-esteem and may lead to loneliness or anti-social behaviour. Older men are far more likely to be affected by overflow incontinence due to the chances of them having an enlarged prostate.

You may have overflow incontinence if you are constantly dribbling urine, or you feel like you can never empty your bladder completely. Overflow incontinence may also cause your urine stream to be very weak when you do go to the toilet (for example your urine stream is a dribble or small drops) and it might be very difficult to even start the flow of urine. Because it is hard to get a strong flow, you might find yourself going to the bathroom much more often. Overflow incontinence means that you may even wet the bed during the night. Unfortunately, one of the worse side effects of overflow incontinence is that urine may stay in the bladder for long periods of time and cause bladder infections.

However, with your doctor’s help and some guidance from Depend you can manage the condition. The following article on overflow incontinence discusses the causes and how to manage it.

What causes overflow incontinence?

Essentially, overflow incontinence is caused when your bladder is stretched beyond its normal capability. This generally results in leakage from the bladder, which may occur during the day or night. This over-stretching can be caused by two factors. The first is some kind of blockage in the bladder or the urethra or another area of the urinary system. The second underlying cause might be a weak bladder contraction, which may be caused by nerve damage or atrophy of the muscles in and around the bladder. When a weak bladder contraction occurs, the bladder tends to enlarge. This swelling distends the bladder’s opening, allowing urine to leak out. Whatever the cause, overflow incontinence makes the bladder fill to over capacity and urine then starts to come out.

The most common cause of the syndrome in men is an enlarged prostate gland. This causes a blockage at the entrance to the urethra. After radiation or surgery for prostate cancer, the urethra and neck of the bladder can also narrow.

Weak bladder muscles are common causes of overflow incontinence in women. Pregnancy, menopause, ovarian tumours or even kidney stones can cause weakened bladder muscles. However, generally women are much less likely to suffer from overflow incontinence than men.

Nerve damage in and around the bladder may be caused by a variety of ailments including Parkinson’s, MS or Diabetes. Certain medications – especially medications for treating mental disorders like depression and psychosis – may also cause the bladder to overfill.

Overflow incontinence treatment

To suitably treat overflow incontinence it must be diagnosed correctly. A common test done by many doctors is the bladder stress test. It may sound complicated but all it entails is ascertaining whether you leak urine when you cough. Your urine may also be analysed 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 the incontinence, it can be as simple as stopping the medication. When the root cause is not known or you simply want to lessen the severity of the syndrome, the following overflow incontinence treatments are recommended:

  • Bladder training: This entails going to the bathroom at certain times during the day so that your bladder never overfills (usually every 2-3 hours).
  • Pelvic floor exercises: As mentioned above, bladder muscle weakness is a common cause of overflow incontinence. Pelvic floor exercises can strengthen your bladder and the surrounding muscles and so lessen the effect overflow incontinence has on your life. Pelvic floor exercises are performed by contracting the muscles around your bladder for around 10 seconds and then relaxing. These exercises can be done numerous times a day. To locate the pelvic floor muscles try to isolate the muscles you use to stop urination mid flow.
  • Incontinence surgery: When the blockage is found to be a tumour or kidney stone that can’t be passed, surgery is often the best option.
  • Incontinence medication: A group of medications called alpha-blockers have been found to be fairly effective in reducing the symptoms of overflow incontinence. These medications work by relaxing the portion of your urinary tract where the bladder flows into the urethra and thereby allows urine to flow out more easily. Talk to your doctor before beginning any type of medication. 
  • Intermittent self-catheterization: You should only try this treatment option if your overflow incontinence is very severe and your urologist has explicitly recommended it. 
  • Products: Depend has a great range of overflow incontinence products designed to minimise the embarrassment and stress that incontinence can cause.

Many people refuse to acknowledge that they suffer from overflow incontinence and so forgo any treatment. However, seeing your doctor does not need to be a worrying experience. Incontinence is a common problem and treatments are available. Book a visit with your GP or Urologist, who can make a diagnosis and recommend a treatment plan. You may feel isolated whilst suffering from these unpleasant symptoms but friends and family can be supportive and considerate while you are going through this difficult time. With help from your doctor, your support network and Depend, you will be back to normal life in no time.