People with overflow incontinence do not feel the urge to urinate. The bladder never empties normally and remains at least partially full; small amounts of urine are leaked on a nearly continuous basis. Weak bladder muscles -- caused by nerve damage from diabetes or other diseases -- or a blocked urethra can be responsible for overflow incontinence.

Overflow incontinence most frequently appears in older men in whom an enlarged prostate hinders the flow of urine; urinary stones or tumors also may block the urethra. Overflow incontinence is rare in women, although sometimes it is caused by fibroid or ovarian tumors. Spinal cord injuries or nervous system disorders are additional causes of overflow incontinence. Some of the symptoms of overflow incontinence are:

• Feeling as though the bladder is never completely empty

• Feeling the urge to urinate, but not being able to

• Passing a dribbling stream of urine, even after spending a long time at the toilet

• Frequently getting up at night to urinate

Although some people with overflow incontinence never have the feeling of a full bladder, they may leak urine day and night.

Risk Factors

Diabetes mellitus
Diabetes is a disease that is characterized by producing large amounts of urine. The bodily changes caused by diabetes can result in nerve damage that affects the bladder. The bladder malfunction specifically associated with diabetes mellitus is called diabetic cystopathy. Diabetic cystopathy progresses with few noticeable symptoms, although patients may lose bladder sensation. Over time, impaired bladder sensation may lead to increased bladder volume and overdistension (overstretching), urinary retention (bladder-emptying) problems, and overflow incontinence. The few existing treatments for diabetic cystopathy include catheterization, timed voids and control of hyperglycemia (too much blood sugar).

Diuretic Medications
Diuretics, or water pills, are prescribed by physicians to increase the amount of urine that is released from a patient's body. Diuretics are commonly used for the treatment of conditions such as hypertension (high blood pressure) and edema (abnormal build-up of fluid in the body). Unfortunately, rapid-acting diuretics can increase the urgency and frequency of urination in some people, particularly those who are elderly and/or bedridden. Urinary incontinence may result.

The unwanted side effects of diuretics can be remedied by lowering or modifying the dosage of the medication: for example, by flexible scheduling of rapid-acting diuretics.

Treatment

Bladder Training/Timed Voiding
Bladder Training/Timed Voiding is the most common treatment option for overflow incontinence.

In timed voiding, the patient fills out a chart that notes all episodes of urination and leaking. The physician then analyzes the chart and highlights the patient's pattern of urination. Using this timetable, the patient can plan to empty his or her bladder before experiencing accidental leakage.

In bladder training, methods of biofeedback and muscle conditioning are used to alter the bladder's schedule for storing and passing urine. The patient is taught to resist the sensation of urgency (the strong desire to pass urine), to postpone urination and to urinate according to a timetable. Bladder training and timed voiding are useful techniques for urge and overflow incontinence.