Overflow incontinence or drip incontinence

In overflow or drip incontinence the bladder is almost literally ‘overflowing’. Because people with overflow incontinence are not able to empty the bladder entirely, the bladder becomes overfilled, eventually resulting in drips of overflow urine.

An estimated 10 to 15% percent of people with incontinence suffer from overflow incontinence. In contrast to other types of incontinence, such as stress incontinence and urge incontinence, this type of incontinence occurs more often in men than in women. In addition, overflow incontinence is more common in older people.

Gender and age are not, however, direct causes of overflow incontinence. There are usually underlying problems such as prostate problems, (benign) prostate enlargement, swelling in the ovaries and uterus, diabetes, or the use of certain medications such as antidepressants.

Overflow incontinence may also be caused by ‘party bladder’, when the urge to urinate is suppressed over a long period of time, thereby weakening the bladder wall. 

How does the bladder work?

In order to understand overflow incontinence, it is important to know how the bladder works. Urine is produced in the kidneys, from where the urine flows to the bladder. If there is a lot of urine in the bladder, the area between the ureters and the urethra is slightly stretched. 

This activates nerves in the bladder wall and sends a signal to the brain that the bladder is filling. This happens when the bladder reaches a volume of about 0.2 liters, but the pressure intensifies as the bladder fills. At the bottom of the bladder is the opening of the urethra, which is where the urine leaves the body. 

When the brain receives the signal, it stimulates the muscles around the bladder wall to contract and send a signal to the sphincter to relax so that the person can urinate. Overflow incontinence occurs if the sensory nerves or the muscles around the bladder do not function properly, making it impossible or difficult to urinate.

What are common causes of overflow incontinence?

Most cases of overflow incontinence arise in older men, since overflow incontinence is often related to prostate problems that can arise from the growth of the prostate that goes along with aging. Because the prostate is positioned against the urethra, it can compress the urethra, making less room for the urine, resulting in the man no longer being able to empty the entire bladder. 

In women, swelling in the ovaries or prolapse of the uterus can cause overflow incontinence, while kidney stones in the urethra and operations of or around the bladder can (temporarily) cause overflow incontinence.

In children, a congenital abnormality may be the cause of overflow incontinence. For people with diabetes, there is a chance that the nerves that control the muscles in the bladder wall have become damaged, causing the bladder muscles to contract incorrectly and the bladder not being completely squeezed during urination. When this happens, the bladder becomes overfilled and overflows, without feeling the urge to go to the toilet.

Solutions for overflow incontinence

Because overflow incontinence can eventually lead to kidney problems, consulting a doctor in time is very important.  Overflow incontinence cannot always be distinguished from other types of incontinence, so a doctor will often perform a physical examination in addition to asking the patient to keep a urination diary.

Many men live with overflow incontinence and other prostate problems for a long time without addressing it. By addressing the issue early, the cause can be examined in time, preventing uncomfortable and serious side effects.

Sometimes overflow incontinence in women can be treated with pelvic floor therapy. Swelling of the ovaries or uterus can be removed through surgery.

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