Overflow Incontinence

What is Overflow Incontinence?

Overflow incontinence happens when the bladder doesn’t empty properly and so it leaks out. You may not get the message to go to the toilet either. The bladder never empties properly and fills up more quickly due to the residual volume. You may find it difficult to start to pass water and that even when you have started; the flow is weak and slow. You might find that you dribble after you have finished passing water. Perhaps you dribble urine all the time, even without noticing.

What causes overflow incontinence?

Overflow incontinence occurs when the muscles of the bladder are not able to squeeze properly to empty the bladder. This can happen in cases where there may have been nerve or muscle damage, perhaps caused by injury, surgery or disease such as Parkinson’s disease, Multiple Sclerosis and Spina Bifida.

As you are not able to empty completely, your bladder and its muscles can become gradually floppy. With larger amounts of urine being held in the bladder all the time urine will leak out when you don’t want it to and you may have a constant feeling of fullness.

In some cases overflow can be due to an obstruction which is making it more difficult for you to empty your bladder. This obstruction can be caused by an enlarged prostate in men, a kidney stone blocking the urethra, constipation, or stricture of the urethra in either men or women, which makes it difficult for urine to flow out of the bladder outlet.

If you are concerned about your problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems.

It would be a good idea to keep a record of your bladder activity for a few days before your appointment with your doctor or nurse. Your doctor will want to investigate the cause of your overflow incontinence and once this has been established, treatment can start.

Whilst your problem is being investigated your bladder will still not be emptying properly and there is a risk that the residual urine which stays in the bladder will become infected, this could cause further complications and problems.

It is important that a way is found to empty the bladder and quite often this will mean using a catheter; classed as a type of management option.  A catheter is a thin, flexible plastic tube that is passed into the bladder through the urethra so that the urine will drain away.

Sometimes the catheter will be left in place so that the urine can be constantly drained into a collection bag which is worn on the leg. There are two kinds of indwelling catheter: urethral and suprapubic.  A urethral catheter is inserted into the bladder through the urethra and a suprapubic catheter is inserted into the bladder through a hole in the abdomen, a few inches below the tummy button.

Another management option is called intermittent self catheterisation.  You can be taught to perform intermittent catheterisation on yourself at an interval specified by your healthcare professional. Most people find that catheterising intermittently is not as difficult or as uncomfortable as they had first imagined.

Normally, either form of catheterisation will only be needed until the cause of obstruction has been treated.

B&BC has a range of Information Sheets available explaining the differences between the different types of catheters, please visit our Resources section for these and other Information Sheets that you may find helpful.