Urinary Retention and Overflow Incontinence: Everything You Need to Know

Being unable to pass urine and fully empty your bladder can negatively impact every moment of your day. The cause can be different factors, which we will discuss below. And often, the result is the same – overflow incontinence (one of several different types of incontinence). Read on, for all the details about urinary retention and its effects. 

Overflow incontinence, sometimes referred to as ‘chronic urinary retention’, happens when your bladder doesn’t empty itself completely, and the urine starts to fill up the bladder again very soon. To compensate for this, the urine starts to leak out.

Urinary retention must be treated urgently because there is a risk of damage to the kidneys. This damage is caused by pressure of urine building up in the bladder and urinary tract. Care staff should be alert and observant for typical urinary retention symptoms to detect the signs like emptying difficulties or frequent urge to urinate.

Symptoms of bladder emptying issues, such as overflow incontinence, could include being unable to pass urine properly. You are usually able to go, but the flow is not what it used to be. You may also feel the need to go often, even during the night.

Typical symptoms of overflow incontinence can include:

• difficulty in starting to urinate

• feeling that the bladder is not emptying even while urinating

• an interrupted or weak urine stream

• frequent urge to urinate and frequent night time urination

Experiencing these symptoms can be incredibly frustrating – you will have to go to the toilet more often and urinating can be laboured as you may struggle to start, before only being able to sustain a weak flow. Sometimes leakage will occur anyway despite these frequent visits.

We have listed below three of the main causes of urinary retention, however this list is not exhaustive so always consult your doctor if you experience overflow incontinence and have questions or concerns.

Obstruction to the flow out of the bladder 

Overflow incontinence may be caused by obstruction to the flow out of the bladder (prostate enlargement, faecal impaction, etc.) which causes urinary difficulty. It’s far more common amongst men than it is with women, as an enlarged prostate is the most common cause of overflow incontinence. An enlarged prostate causes a blockage of the tube connecting the bladder to the outside (urethra) and increases the pressure on your bladder meaning urine cannot pass through, causing leakage.

Malfunctioning bladder muscle 

Overflow incontinence can also be caused by the bladder muscle not working as effectively as it should, giving you trouble with squeezing properly to empty the bladder – leading to urinary retention. The bladder muscle not working as effectively as it should might be caused by damage to the nerves that control the bladder, which can occur in conditions such as Diabetes, Multiple Sclerosis (MS) or spinal cord injury, or a side effect of some medications.

Fowler syndrome 

Fowler syndrome is also another cause of urinary retention. Usually, this occurs in young women and it can be very debilatiting. The problem is caused by the sphincter’s failure to relax to allow urine to be passed normally. There is no neurological disorder associated with it, however many women with Fowler syndrome also have polycystic ovaries. This syndrome can often cause UTIs, read here for more information on this often neglected disease. 

If your bladder is not emptying properly, it is important to urgently seek professional help in order to avoid the pressure of urine building up in the bladder and urinary tract which could also affect the kidneys. You can see a doctor or a continence nurse. Keep track of your toilet habits and bladder activity a couple of days before your appointment. That’s a good way to prepare for the visit and will make it easier for your healthcare professional to set a diagnosis.
 
In order to understand the problem better, your doctor will do a physical examination. The findings from this examination might lead you to other professionals, such as a urologist (a doctor who specialises in diseases in the urinary tract) or a neurologist (a doctor who specialises in diseases of the brain and nervous system) if that’s necessary. When a proper diagnosis is set, your doctor will know the right urinary retention treatment.
 
For men with an enlarged prostate gland, there are a number of options to reduce the size of the prostate to remove the obstruction to the flow out of the bladder. There are a number of medications available, as well as other options (including surgery). It’s important to talk the options through with your urologist.

If you have problems emptying your bladder, there are methods you can do yourself to help. 

In particular and starting right away:
 
1. Position yourself properly on the toilet to ease urinary retention
 
Always make sure you are in a proper position that makes bladder emptying easier and that you sit comfortably on the toilet with good support for your feet. Double or triple voiding may help you with bladder emptying. This is done by first sitting down and voiding normally. Then, after finishing, you stand up and sit back down again. This can encourage more urine to pass through. 

With the go-ahead from the doctor:
 
2. Use a catheter for urinary difficulty
 
Sometimes your doctor will decide a catheter is required to fully empty the bladder completely. A catheter is a very thin and flexible tube made of plastic that is carefully passed through the urethra and into the bladder to help empty it.
 
If you self-catheterise, the general recommendation is to empty the bladder at regular intervals. You can be taught to self-catheterise by your doctor or nurse. It’s a fairly simple process, and easy to keep private at work or in other social situations as the single-use catheters are small enough to put in your pocket and easy to dispose of after use. 
 
3. Medications, surgery and incontinence pads 

Sometimes the obstruction can be treated with medications, if not, surgery can be another option. Using incontinence pads  or other underwear solutions to catch leaks and protect your clothing is another thing you can easily do on your own.

As you can see, there are many different urinary retention solutions, and if you are struggling, be sure to speak to a medical professional to help ease your symptoms. In the meantime, take a look at our incontinence products for women and men designed to help manage bladder leakage.