Overflow incontinence occurs when the bladder does not empty properly, usually due to obstruction.
The urine left in the bladder after emptying is called a residual urine.
If there is a large residual then leakage will occur as a persistant dribble, like an overflowing basin.
Wetting the bed is also likely.
Repeated urinary tract infections can indicate residual urine, as it can cause a stagnant pool environment for the growth of bacteria.
Pain and inability to pass urine indicate complete obstruction, known as retention of urine.
In this situation, urgent medical assistance is required.
Symptoms of overflow incontinence - Poor stream
- Hesitancy - takes a long time to get going
- Takes a long time to urinate
- Straining to urinate using abdominal muscles
- May not be aware of having a full bladder
- Post-micturition dribble - continues to dribble after the flow has stopped
- Night incontinence - wetting the bed
- Up many times in the night
- Poor sleep
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Risk factors
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Surgery, a resection of the prostrate gland (TURP), is necessary to relieve the obstruction. This should not interfere with bladder control after the surgery because the external sphincter will not have been interfered with during the operation.
Residual urine may also occur in women after having a hysterectomy. Nerve damage can cause overflow incontinence, as it becomes difficult to know when the bladder is full; the brain does not receive the signals to make us aware of the need to urinate.
The bladder muscle can be overstretched and lose its ability to contract after epidural anaesthesia if there has been inappropriate care of the bladder during a procedure such as surgery or childbirth. The only treatment available is self-intermittent catheterisation.
Constipation which leads to a distended bowel can obstruct the bladder outlet.
If residual urine is present then the formation of bladder stones is more common as there is a build-up of urates.
Professional help should be sought when there is narrowing of the urethra.
TURP
The conventional treatment for prostate enlargement, known as BPH (benign prostatic hyperplasia), is surgery.
A transurethral resection of prostate (TURP) is carried out by inserting a small telescope-like instrument into the penile urethra under general or local anaesthetic. The prostate is then resected or cut away, so enlarging the opening for the urine to pass, a little like coring an apple. This procedure can be done under local or general anaesthetic
As operations are often delayed until the prostate is 'ripe', medication may be offered for patients on the waiting list. Alpha-blockers are sometimes used as they act by relaxing smooth muscle within the prostate and bladder neck. They do not cure the condition, but offer short-term relief by reducing the severity of symptoms.
The risks are those associated with general anaesthesia and in addition impotence, as the ejaculate goes backwards into the bladder. Stress incontinence should not be a complication, but it does occur in some circumstances.
20/05/2009