Incomplete emptying of the bladder
Overflow Incontinence is when there is frequent or constant dribbling of urine due to incomplete emptying of the bladder. Overflow incontinence occurs when the muscles of the bladder are not able to squeeze properly to empty the bladder.
Symptoms & Causes
Causes: If you cannot fully empty your bladder, this is a sign of overflow incontinence. Causes can include:
- Weak bladder muscles
- Nerve damage
- Conditions tat block the flow of urine (e.g. tumors or enlarged prostate)
- Side effects of some medications
If your bladder cannot fully empty, it may lead to infections or other problems.
Symptoms: If you experience overflow incontinence, you’ll have frequent or constant urine leakage due to the bladder not emptying completely.
Risk Factors & Complications
Gender and age are not the only factors – according to the Urology Care Foundation, risk factors of getting urinary incontinence include:
- Pregnancy and childbirth
- Overweight or obesity
- Chronic coughing
- Nerve injuries to the lower back
- Pelvic surgery
- Caucasian or Hispanic race
If urinary incontinence goes untreated, it can lead to infections and other problems. While physical discomfort affects your daily life, the emotional stress of dealing with urinary incontinence is an important factor to consider. The Urology Care Foundation, official foundation of the American Urological Association, says many people who have urinary incontinence don’t tell anyone about their symptoms; they’re embarrassed and believe nothing can be done, and so suffer in silence. Dealing with urinary incontinence without treatment can affect the emotional, psychological and social life – those who suffer are not able to live their full lives, afraid to stray too far from a toilet.
Many people think urinary incontinence is just part of getting older. It’s not. And it can be treated, or even cured.
The Urinary Care Foundation says a quarter to a third of men and women in the U.S. suffer from urinary incontinence. The exact number is unknown because it’s not a problem easily talked about; those affected may be embarrassed or think nothing can be done.
Below are the best ways to treat overflow incontinence.
Absorbent Pads & Catheters
Absorbent products may be used to manage any form of incontinence. However, incontinence products are NOT a TREATMENT for incontinence; for some individuals, urinary incontinence products are a temporary strategy until they address and resolve the underlying cause of their incontinence. Most people find the use of pads, diapers and bladder supports to be extremely inconvenient, expensive and impacts their quality of life.
According to WebMD, absorbent products, such as adult diapers, plastic-coated underwear, pads or panty liners that attach to underwear can be used if:
- Your incontinence is not a significant disruption in your life
- You are waiting for another treatment for incontinence to take effect
- Your incontinence cannot be treated by other means
- You prefer to use absorbent products rather than medicines or surgery
Absorbent products are an effective way to relieve the embarrassment and discomfort of urine leakage.
Risks when using absorbent products include irritation around the groin area and an increased risk of urinary tract infections.
Product options include:
- Depends® Adult Underwear
- Tena Serenity®
- Poise® Pads
- Always Discreet®
A catheter is a flexible tube placed in your bladder. Your doctor may recommend inserting a catheter into the urethra to drain your bladder multiple times a day if your incontinence is due to the bladder not properly emptying, such as with overflow incontinence.
The Urology Care Foundation mentions the following catheter and device options can help men and women of all ages to manage bladder problems:
- Indwelling catheters: This catheter stays in your bladder all day and night. There are two types – Indwelling “Foley” catheters are placed in your urethra. “Suprapublic” catheters go above your pubic bone through a small surgical cut in the belly. With both types, a balloon holds the tube in your bladder. They also drain urine into a bag outside the body.
- Intermittent catheterization: Also called “in and out” catheterization, it is inserted in the urethra three to five times a day. After your bladder empties, you throw the catheter away.
Risks of using catheters include infection or possible leakage during use.
Treatment of the pelvic floor is a specialized aspect of physical and occupational therapy. There are a wide range of issues that can arise from weakness in the muscles of the pelvic floor or around the organs inside the pelvis such as urinary frequency, urgency or problems with incontinence and interstitial cystitis.
Patients typically attend in-office appointments 2-3 times per week for a duration of 12 weeks. Treatment requires manual digital manipulation of the external and internal tissues of the pelvis, vagina and/or rectum. This type of therapy is fairly intimate and can be uncomfortable for some patients.
Therapists will often utilize bladder training, biofeedback, pelvic floor muscle exercises and electrical muscle stimulation. For overflow incontinence, your doctor will most likely recommend biofeedback.
Biofeedback is a technique that provides you with real-time information about activity in the bladder and pelvic muscles to help you learn to contract these muscles properly. Sensors are placed internally and/or externally within or around the vagina or rectum. Many trained specialists, such as physical therapists, occupational therapists, and nurses provide these services. Patients typically require 2-3 in-office visits per week to learn how to isolate and contract the pelvic floor muscles while using biofeedback to guide performance. In addition, there are biofeedback products available for home use.
Medical devices can be used to help build and strengthen pelvic floor muscles, treating incontinence at the issue instead of just managing the result. According to the Mayo Clinic, “gentle electrical stimulation can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months.”
Sacral Nerve Stimulation
The sacral nerves control the bladder and the muscles related to urinary function. If the brain and sacral nerves don’t communicate correctly, the nerves cannot tell the bladder to function properly. This communication problem may lead to symptoms of OAB. Neuromodulation targets these symptoms by stimulating the sacral nerves.
An electronic pacemaker-like device is implanted into your buttock area and a thin wire with an electrode tip is placed near the sacral nerve to deliver electrical impulses. Sacral Nerve Stimulation is an invasive, surgical procedure.
Note: Sacral nerve stimulation does nothing to strengthen the pelvic floor muscles.
Doctors do not typically recommend drug treatment for overflow incontinence.
In men with urge or overflow incontinence, alpha blockers help to relax bladder beck muscles and muscle fibers found in the prostate to make it easier to empty the bladder.
Another way to prevent leakage from stress incontinence is to inject synthetic bulking agents into the tissues around the urethra boosting the size of the urethra lining and creates resistance against the flow of urine from the bladder.
Injections must be repeated every 12 to 18 months and are only helpful against stress incontinence. Potential side effects include pain at injection site and or damage to the urethra.
Note: Bulking Agents do nothing to strengthen the pelvic floor muscles.
According to the Cleveland Clinic, approximately 11 percent of patients seeking treatment for urinary incontinence will undergo surgery.
Sling surgery is often done as an outpatient procedure. One option is to place the bladder in a “sling” – a piece of tissue or synthetic material is used to create a sling around the bladder neck and urethra in order to provide support to keep the urethra closed in order to prevent leaks. As with any surgical procedure, please discuss thoroughly with your physician the benefits and possible complications that may exist.
Note: Does nothing to strengthen the pelvic floor muscles.
Bladder neck suspension
This procedure will support your bladder neck and urethra. The bladder neck is an area of muscle where the bladder connects to the urethra. The surgery involves an abdominal incision, so it can be done during general or spinal anesthesia.
If a woman has mixed incontinence as well as a pelvic organ prolapse, surgery may include a combination of sling and prolapse surgery.
Artificial urinary sphincter
For men, a small, fluid-filled right is implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. When you do urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine to flow.