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Overflow Incontinence - What Is It, Causes, Diagnosis and Treatment.



bladder structure
You get a sudden urge to urinate and rush to the toilet. But, as you start to urinate, you notice that the flow is not uniform.

The continuous start and stop action of the urine flow not only irritates the hell out of you, but it also leaves you dissatisfied as you can still feel that your bladder hasn’t emptied completely.

As if that wasn’t enough, constant leakage of urine results in soiling of clothes and even bed wetting during the night.

These are all symptoms of a highly embarrassing condition known as overflow incontinence, which is normally seen in men, with older folks getting affected by it the most.  

What is Overflow Incontinence?

Overflow incontinence account for roughly 10-15% of all urinary incontinence (the inability to urinate efficiently). It occurs when the bladder (the storage unit for urine in the body) does not get emptied fully. As a result, large volumes of urine begin to accumulate in the bladder, thus causing it to overstretch.

In order to preserve its structural integrity, the bladder is forced to ‘overflow’ and this is what causes the constant leaking of urine. Perhaps, the worst effect of it all is that prolonged presence of urine in the bladder leads to infections in the area.

Why Is Overflow Incontinence Caused?

Bladder fullness in people suffering from overflow incontinence can be attributed to two major factors. The first reason could be due to an obstacle, either in the bladder or another area of the urinary system that is blocking the outflow of urine. A typical example would be an enlarged prostate gland squeezing the urethra (a condition referred to as Benign Prostatic Hypertrophy), usually seen in older men who have crossed the age of 60.

Vertical section of bladder, penis, and urethra.
(Photo credit: Wikipedia)
The other reason may be that the bladder muscles have lost their power to contract and therefore cannot squeeze out the urine into the urinary pipe and out of your body. This loss in contractility may be experienced by people who have just undergone a pelvic or lower back surgery.

 In women, weak bladder muscles are the main cause for overflow incontinence. In turn, frail bladder muscles are influenced by aspects like ovarian tumor, pregnancy and menopause.

Other minor factors that might result in overflow incontinence include damaged nerves around the bladder attributable to conditions like diabetes and Parkinson’s disease, and side-effects of medications like antidepressants and antipsychotics.


Diagnosis of Overflow Incontinence

Your doctor will begin the diagnosis by asking you a number of questions regarding your urination pattern to check if the symptoms match that of urinary incontinence. Then he/she will perform a thorough examination to determine the problem. Based on the information gathered from the examination, your doctor will then either refer you to an urologist (specialist in disorders of the urinary system) or neurologist (specialist in treating nervous system problems).

As for tests, they may include bladder stress test (to determine urine leakage when you cough), Q-tip test (for measuring weakness if any in the tissues surrounding the bladder), catheterization (detection technique for overflow incontinence), urinalysis (testing of the urine sample for infection, kidney stone etc) and/or ultrasound.    

Treatment And Overflow Incontinence Management    

Based on the diagnosis and detection of the underlying problem causing overflow incontinence to occur, treatments will also vary accordingly. As such, certain classes of drugs like alpha-adrenergic blockers are used to treat obstruction in the urethra owing to muscle constriction there. Similarly, in case of enlarged prostate glands causing the problem, surgery may be deemed necessary.

Other techniques such as self-catheterization, bladder training, pelvic floor exercises and use of incontinence products provide solutions to manage overflow incontinence issues.





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