A symptom of overflow incontinence is increased residual urine volume, or urinary retention This is often due to an inability to contract the detrusor muscle, autonomic neuropathy, or an outlet obstruction.
Patients may experience continuous, involuntary urine leakage, even after voiding. This is because the urine may overflow from the bladder as the bladder pressure is higher than the urethral sphincter closure pressure.
Urinating more than 8 times in 24 hours is a symptom of urge incontinence. During urination, the patient will void only a small amount, even if they feel the sensation of having a full bladder.
Autonomic neuropathy may cause an underactive bladder and result in overflow incontinence. This may be caused by spinal nerve damage which can decrease neural signals from the bladder, therefore inhibiting the bladder from contracting efficiently when voiding.
Narrowing or obstruction of the bladder neck may be caused by a tumor, kidney stones, or in men, benign prostate hyperplasia. Alpha-adrenergic agonist medications may also cause overflow incontinence by contracting the bladder neck, causing urinary retention.
The detrusor muscle is in the wall of the bladder that allows the bladder to store urine, in addition to contracting when voiding to release urine. In patients with overflow incontinence, the detrusor muscle activity is decreased or weak, resulting in incomplete emptying of the bladder.
Bethanechol is a cholinergic medication that may be used to treat overflow incontinence by activating muscarinic receptors in the bladder and stimulating muscle contraction to void. Though it is not always effective, it is still commonly used.
Catheterization may be used as a treatment to empty the bladder when it cannot empty because of weak muscle tone or spinal cord injury. Patients may often self-catheterize themselves multiple times each day to prevent overflow incontinence.
Sacral neuromodulation is a form of electrical stimulation therapy that controls symptoms of urinary incontinence through direct modulation of the nerve activity. In this procedure, a generator device is usually placed through the sacral foramen to stimulate the S3 sacral nerve to regulate detrusor muscle contractions.
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