Overflow Incontinence

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Treatment of Overflow Incontinence

When tumors or urinary stones are present, treatment involves removal of the obstruction.

Medication

Alpha-1-adrenergic blocking agents are used to treat benign prostatic hyperplasia. Alpha blockers relax striated and smooth muscle, decreasing urethral resistance and relieving symptoms. There are three drugs commonly prescribed for treatment of BPH and associated overflow incontinence:

• Doxazosin mesylate (Cardura®), 1-8 mg, once daily
• Tamulosin hydrochloride (Flomax®), 0.4-0.8 mg, once daily
• Terazosin hycrochloride (Hytrin®), 1-10 mg, once daily

Common side effects experienced with this type of medication include the following:

• dizziness,
• fatigue, and
• headache.

An anticholinergic medication like oxybutynin chloride (Ditropan®) can be used to treat overflow incontinence associated with a nervous system disorder (e.g., Parkinson's disease, multiple sclerosis, cerebral palsy). Oxybutynin relaxes bladder smooth muscle. The typical dosage is 2.5-5.0 mg, taken orally, 3 to 4 times per day.

Side effects experienced with this medication include the following:

• Constipation
• Dry mouth
• Dry skin
• Nausea
• Blurred vision

Intermittent Self-Catheterization

Medical treatment for patients with a neurogenic bladder and overflow incontinence is fairly limited. Intermittent self-catheterization is a safe and effective method of completely emptying the bladder every 3 to 8 hours, or as recommended by a physician, to keep urine volume low. Fluid intake is directly related to urine output and the frequency of catheterization. Normal fluid intake is 48 to 64 ounces per day.

Catheterization should not be skipped for any reason. If the catheter accidentally drops and cannot be washed properly, wipe it off and remove as much dirt as possible before using it. It is more important to empty your bladder than to have an absolutely clean catheter. The risk for infection is greater from a full bladder than from an unwashed catheter.

These signs and symptoms may indicate that the bladder needs emptying:

• Chills
• Distended bladder
• Feeling of fullness
• Headache
• Perspiration
• Restlessness

See instructions on self-catheterization.

Complications

If any of these signs or symptoms appears, the physician should be called:

• Absence of urine for 6 to 8 hours
• Back pain
• Blood in urine
• Cloudy urine
• Fever
• Inability to keep urine volume within recommended amount
• Inability to urinate when abdomen is distended
• Nausea
• Sudden pain or bleeding when inserting the catheter
• Urine with foul odor

Patients with spinal cord injuries who experience a severe, pounding headache should immediately self-catheterize to empty their bladder and then call their physician. The headache may indicate unresolved autonomic dysreflexia.

This syndrome is characterized by sudden rise in blood pressure (paroxysmal hypertension), facial flushing, nasal congestion, slowed heart rate (bradycardia), excessive sweating, and headache. The symptoms are triggered by an exaggerated autonomic response to a distended bladder. The autonomic nervous system performs many functions, including stimulation of smooth and cardiac muscle, and blood pressure regulation.

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