Overflow Incontinence

In this condition, patients never feel the urge to urinate, the bladder never empties, and small amounts of urine leak continuously. Overflow incontinence is prevalent in older men with an enlarged prostate and is rare in women.

Symptoms include the following:

• Bladder never feels empty

• Frequent nighttime urinate

• Inability to void, even when the urge is felt

• Urine dribbles, even after voiding

Causes of overflow incontinence

Conditions that may lead to overflow incontinence include the following:

• Benign prostatic hyperplasia (BPH; enlarged prostate)

• Neurogenic bladder (underactive)

• Tumors

• Urinary stones

Overflow incontinence is a common symptom of benign prostatic hyperplasia. The prostate is located directly beneath the bladder and in front of the rectum. The upper portion of the urethra passes through the prostate, so when the gland becomes enlarged it may obstruct the passage of urine through the urethra.

Neurogenic bladder associated with overflow incontinence is caused by the loss of sensation of bladder fullness due to damage or obstruction of sacral nerves (located in the five vertebrae above the sacrum).

This may result from certain types of surgery on the spinal cord, sacral spinal tumors, or birth defects. It also may be a complication of various diseases such as diabetes mellitus and polio.

Tumors and urinary stones can block the urethra and cause overflow incontinence.

Diagnosis involves identifying the type and severity of the disorder. Depending on the information gained from a standard medical history and physical examination, urologists may prescribe one or more diagnostic procedures to make an accurate diagnosis and develop an effective treatment plan.

Treatment of Overflow Incontinence

When tumors or urinary stones are present, treatment involves removal of the obstruction.

Medication for overflow incontinence

Alpha-1-adrenergic blocking agents are used to treat benign prostatic hyperplasia. Alpha blockers relax striated and smooth muscle, decreasing urethral resistance and relieving symptoms. There are three drugs commonly prescribed for treatment of BPH and associated overflow incontinence:

• Doxazosin mesylate (Cardura®), 1-8 mg, once daily

• Tamulosin hydrochloride (Flomax®), 0.4-0.8 mg, once daily

• Terazosin hycrochloride (Hytrin®), 1-10 mg, once daily

Common side effects experienced with this type of medication include the following:

• dizziness,

• fatigue, and

• headache.

An anticholinergic medication like oxybutynin chloride (Ditropan®) can be used to treat overflow incontinence associated with a nervous system disorder (e.g., Parkinson's disease, multiple sclerosis, cerebral palsy). Oxybutynin relaxes bladder smooth muscle. The typical dosage is 2.5-5.0 mg, taken orally, 3 to 4 times per day.

Side effects experienced with this medication include the following:

• Constipation

• Dry mouth

• Dry skin

• Nausea

• Blurred vision

Intermittent Self-Catheterization

Medical treatment for patients with a neurogenic bladder and overflow incontinence is fairly limited.

Intermittent self-catheterization is a safe and effective method of completely emptying the bladder every 3 to 8 hours, or as recommended by a doctor, to keep urine volume low.

Fluid intake is directly related to urine output and the frequency of catheterization. Normal fluid intake is 48 to 64 ounces per day.

Catheterization should not be skipped for any reason. If the catheter accidentally drops and cannot be washed properly, wipe it off and remove as much dirt as possible before using it. It is more important to empty your bladder than to have an absolutely clean catheter. The risk for infection is greater from a full bladder than from an unwashed catheter.

These signs and symptoms may indicate that the bladder needs emptying:

• Chills

• Distended bladder

• Feeling of fullness

• Headache

• Perspiration

• Restlessness

For instructions on self-catheterization click here.

Complications

If any of these signs or symptoms appears, the physician should be called:

• Absence of urine for 6 to 8 hours

• Back pain

• Blood in urine

• Cloudy urine

• Fever

• Inability to keep urine volume within recommended amount

• Inability to urinate when abdomen is distended

• Nausea

• Sudden pain or bleeding when inserting the catheter

• Urine with foul odor

Patients with spinal cord injuries who experience a severe, pounding headache should immediately self-catheterize to empty their bladder and then call their physician. The headache may indicate unresolved autonomic dysreflexia.

This syndrome is characterized by sudden rise in blood pressure (paroxysmal hypertension), facial flushing, nasal congestion, slowed heart rate (bradycardia), excessive sweating, and headache.

The symptoms are triggered by an exaggerated autonomic response to a distended bladder. The autonomic nervous system performs many functions, including stimulation of smooth and cardiac muscle, and blood pressure regulation.

The above opinionated views and information serves to educated and informed consumer .  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. .It should not replaced professional advise and consultation.A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions