Living with Overflow Incontinence

What is overflow incontinence?

This type of incontinence is called ‘overflow’ because it happens when the bladder either can’t empty fully or has a blockage that results in urinary retention, causing the bladder to literally overflows.

Overflow incontinence can be experienced in different ways, with some people never feeling like their bladder is empty (even if they’ve just been to the toilet) and others not sensing when it’s full.

Because the bladder is always partially filled, the capacity to hold more is restricted, meaning it fills up faster and requires frequent voiding – which is often involuntary. This can severely interrupt daily activities, including sleep.

Any pressure applied to the often-over-full bladder will likely result in a leak. This can happen from simple activities such as laughing, sneezing, coughing, standing up, sitting down or even rolling over in bed when you’re asleep.

When people with overflow incontinence go to the toilet, they can find starting and maintaining a flow challenging. They can also experience a weak and slow stream and the need to push or strain to ensure the bladder is emptying. This adds to the difficulty of knowing when the bladder is actually empty. It’s also not uncommon to experience a ‘dribble’ after you’ve finished, losing a small amount of urine just after you leave the bathroom.

The causes of overflow incontinence

The two leading causes of overflow incontinence are the inability to empty the bladder fully or a blockage, and both of these can have several underlying reasons.

• Inability to empty the bladder 

The issue underlying the inability to empty the bladder properly can be chronic, meaning it develops slowly over time. The muscle that is used to expel urine, the detrusor, is used less and gradually become increasingly weakened, exacerbating the problem.

Diseases like diabetes, multiple sclerosis, stroke, spina bifida or Parkinson's disease can interfere with the nerves that deliver the sensation of a full or empty bladder. The same outcome can occur from pelvic injury or even pelvic surgery.

• A blockage

The most probable cause for a blockage among older men is an enlarged prostate gland. The urethra (the tube that transports urine from the bladder to outside the body) runs through this gland, so it makes sense that if it has enlarged, it can squeeze the urethra, restricting its function.
Among women, a prolapse is a likely cause. This is when pelvic organs have shifted or dropped out of place, putting additional pressure on the bladder and compromise the function of the urethra,

A blockage can also be caused by constipation, with a bowel full of hard faeces pushing against the bladder and urethra.

For men and women, kidney or bladder stones may be the issue, as well as tumours formed by bladder cancer

Complications of overflow incontinence

When urine remains in the bladder for longer than usual, there is the risk of developing an infection. This can spread, developing into a kidney infection medically known as pyelonephritis, which can leave you feeling very unwell.

Further, if a blockage becomes complete and no urine can pass at all, it can be life-threatening so you must seek medical attention at your nearest emergency room as soon as possible. You can read more in this article, Is Urinary Retention Dangerous?

When to see a doctor
If you are experiencing any continence issues, you must discuss them with your doctor. While most underlying causes may not pose serious health risks, ones like cancer do, so it’s vital that the cause is investigated and correctly diagnosed. Identifying the underlying cause will also inform you of the best treatment.

Some people feel uncomfortable or embarrassed to discuss their symptoms with their doctor, but as health care professionals, they have seen and heard it all before. If you are feeling anxious, this article, Questions for the Doctor will help you prepare for your appointment.

Treatments for overflow incontinence

As mentioned, the treatment will depend on the cause.

For immediate relief and in the case of a complete blockage, a catheter will be used. This is a thin, flexible tube that’s inserted through the urethra and into the bladder to drain the urine.

‘Double voiding’ is a technique often recommended for treating overflow incontinence. This is when a few minutes after you’ve urinated, you try again. For women, the action of standing up and sitting down can induce further voiding and for men, zipping up and walking out, then returning may do the trick.

If the issue is due to medications, your doctor will review what you’re taking and should be able to make adjustments to improve the situation. Be sure to tell them of all medications you regularly take, including supplements, herbal remedies and any over-the-counter drugs.

For men with an enlarged prostate, your doctor will recommend the best treatment depending on your circumstances. You can read more about enlarged prostate glands and prostate surgery here

Similarly, women who’ve had a prolapse may be offered an exercise program to strengthen the pelvic floor muscle and pull organs back into place, or an insert or surgery – depending on the severity. You can read more about the different types of prolapses, causes and treatments here

If diseases like Parkinson’s, MS or stroke are the cause, although they may not be able to be addressed, there are ways to manage overflow incontinence to ensure it doesn’t overly disrupt your day.

Living with overflow incontinence

Overflow incontinence can be improved with pelvic floor exercises. By strengthening this muscle, which supports the pelvic organs and assists in the control of bladder and bowel function, your ability to ‘hold on’ can be significantly improved. To find out more about pelvic floor muscle exercises, head over to the Prevention & Exercise section on the TENA website, where you’ll find articles on yoga and instructional videos for Beginner, Intermediate and Master classes for men and women.

For some cases, using a catheter will be the long-term solution to manage the condition. This can either be intermittent, where the user is trained on how to comfortably insert the catheter and drain the bladder three or four times throughout the day. Once people get the hang of it, it becomes a quick and easy process. Others may have a catheter that stays in and drains urine into a bag that’s discreetly strapped to your leg, under your clothes.

Good lifestyle and bathroom habits will also help manage overflow incontinence. Avoid food and drinks that can irritate the bladder, like caffeine, alcohol, carbonated drinks, chilli, spicy foods, tomato and citrus. Make sure you’re eating a healthy diet rich in fibre, drinking enough water and exercising to keep weight within the normal range and avoid constipation

Using an absorbent, disposable product is also a good solution, long or short term. These products are soft, discreet and comfortable as well as being specifically designed to quickly absorb and lock-away urine to keep you dry and odour-free.

Managing incontinence

If you are experience bladder or bowel leaks, you may feel more comfortable with the security of an absorbent, disposable product while having the cause investigated.

The TENA range includes super small TENA Liners, an extensive range of TENA Pads and TENA Pants that looks and feel just like regular underwear. All are designed to handle the thinner, faster flow of a weak bladder to keep you dry and odour-free.

Check out the TENA Product Finder Tool, and Free Samples to find the product that best suits your needs.

Sources

• https://www.healthlinkbc.ca/health-topics/uh1227
• https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/overflow-incontinence/
• https://www.continence.org.au/pages/overflow-incontinence.html

Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.