What Is Overflow Incontinence?

Overflow incontinence is one of the 5 types of urinary incontinence that can affect women. It is less common than stress incontinence, urge incontinence, or mixed incontinence (which is a combination of stress and urge incontinence).

Overflow incontinence affects both men and women. In fact, it is more common in men. But in this article, we’ll focus on female overflow incontinence. 

Overflow incontinence occurs when the bladder fails to empty fully during peeing (an unsteady urine dribble - or weak urine flow - is a telltale sign.) Because your kidneys continually produce urine, not emptying your bladder can lead it to overflow later, without warning.

What Are the Symptoms of Overflow Incontinence?

All urinary incontinence is characterized by involuntary urine leakage. But there are different kinds of urinary incontinence, and while the result is the same, they may manifest differently.

It may be difficult for a non-medical professional to differentiate between the different kinds of incontinence. But overflow incontinence has some notable characteristics, including the following overflow incontinence symptoms:

• An unsteady, dribble-like flow of urine (i.e., not a strong urine stream)
• A stream of urine that stops and starts during peeing
• Feeling that your bladder is full even after you urinate
• Leaking urine while asleep
• Difficulty urinating even when you need to go
• Frequent urinary tract infections (UTIs)

If you experience any of the above involuntary urine leakage, you may be experiencing overflow incontinence. However, a doctor should be able to give you a certain diagnosis.

What Causes Overflow Incontinence?

Overflow incontinence has a few different possible causes. You will need to work with your doctor to determine the exact kind of incontinence you are experiencing, as well as the particular cause of it.

Some of the possible causes of overflow incontinence include:

Blockages

Blockages in the urinary tract or urethra (that carries urine out of the body) can often be the cause of overflow incontinence. Blockages can be caused by unusual growths, bladder stones, urinary stones, scar tissue, or swelling. Blockages can also be caused by other surgeries, which may cause the bladder to drop in the abdomen.  

Weak Bladder Muscles

Overflow incontinence can be caused by weak bladder muscles, which are unable to squeeze the bladder empty. Bladder muscles (and pelvic floor muscles more generally) can be weakened by childbirth, pregnancy, or by surgery. Pelvic floor exercises (aka Kegels) are often recommended to strengthen the pelvic muscles.

Underactive Bladder

Underactive bladder (UAB) is defined by the International Continence Society as a symptom complex characterized by a slow urinary stream, hesitancy, and straining to void, with or without a feeling of incomplete bladder emptying, sometimes with storage symptoms. (Source)

Nerve Damage

Diseases like diabetes, alcoholism, Parkinson's disease, multiple sclerosis (MS) can cause nerve damage that affects the ability to sense a full bladder or that reduces the ability of the bladder to contract.

Medications and Other Conditions

Certain medications, in particular anticonvulsants and antidepressants, may affect signals to the bladder.

Overflow Incontinence Can Also Result in Urinary Tract Infection (UTI)

In addition to the distress this kind of sudden incontinence can cause, it also puts you at risk for urinary tract infections. This is because urine should be expelled from the body, but if you don't empty the bladder, the urine that remains can become a breeding ground for bacteria.

What Tests Will My Doctor Perform to Diagnose Overflow Incontinence?

Your doctor will consult your medical history, ask you a number of questions to diagnose overflow incontinence, and will likely perform certain tests.

To help you prepare for the appointment, it’s worth making some notes (or keep a bladder diary) in the days leading up to your appointment, including:

• How frequently do you use the bathroom
• Whether it’s difficult for you to start or stop peeing
• If there are certain activities that result in urine leakage
• Any pain or burning sensation when peeing
• A list of current medications and supplements

Tests your doctor may perform could include:

• A bladder stress test to see if you leak pee when coughing or exerting yourself (read more about stress incontinence here)
• Urinalysis to check your urine for infection or evidence of kidney stones
• Catheterization after you’ve used the bathroom to see if there is still urine left in the bladder 
• Ultrasound to measure how much urine the bladder holds when full and after you empty the bladder

If these tests are unclear, your doctor may order further tests to be conducted.

How Is Overflow Incontinence Treated in Women?

The treatment for overflow incontinence will differ depending on the cause. If, for example, a blockage is found, you may require surgery or other treatment to remove that blockage.

If your bladder muscles are weakened, your doctor may recommend bladder training. Bladder training involves taking bathroom breaks to empty your bladder at regularly timed intervals. By ensuring you empty your bladder completely, frequently, you minimize the chances of unexpected urine leakage. Over time, the time between breaks can be increased. 

Double voiding can also be a recommended tactic. This involves using the bathroom twice (especially before bedtime), thereby completely emptying the bladder, so you are less likely to leak urine or dribble urine at night.

Women with overflow incontinence can also be treated with a catheter (a thin tube that carries urine out of the body), either intermittent self-inserted or continuous catheterization.

While medications are available to treat overflow incontinence in men, medication is rarely used to treat overflow incontinence in women. However, if overflow incontinence is a side effect of medications, you can work with your doctor to implore alternatives without side effects.

Overflow incontinence is a difficult type of incontinence to treat. While you explore treatment options with your healthcare provider, you can also explore products to help you stay active and social. Leakproof underwear comes with different absorbency levels.

Super absorbent Knix leakproof underwear is a solid choice. Products like these can be a game-changer for those experiencing female urinary incontinence, allowing them to remain active and social while exploring treatment options. 

More Common Forms of Urinary Incontinence in Women

If you’re self-diagnosing the kind of urinary incontinence you have, it’s probably worth a trip to the doctor’s office. There are other kinds of incontinence that are more common, and your doctor will help you understand what type you are experiencing (the differences can be subtle and sometimes overlapping.) Two of the more common types are urge incontinence and stress urinary incontinence, which we’ll review briefly below:

1. Urge Incontinence

We all experience the urge to pee - it can even be urgent when we’ve had excess fluid intake (alcohol or carbonated drinks in particular) or have been stuck without access to a bathroom for too long. But most of us can manage to ‘hold it’ until we find a washroom.

For some people, though, an urgent urge to urinate comes seemingly out of nowhere. It can happen even if they’ve urinated recently and or felt completely normal just a minute ago. And if they can’t get to a bathroom in time, an accident may happen. This is urge incontinence.

Urge incontinence may be caused by a miscommunication between your brain and your bladder. There can be false messages that the bladder is full and needs emptying. Or “too late” nerve signals that you need to urinate.

Because it also involves the brain, urge incontinence can sometimes be linked to neurological conditions like Parkinson’s Disease and multiple sclerosis (MS). But urge incontinence can also be caused by pregnancy (which puts pressure on the bladder), childbirth, menopause, or trauma from surgery.

Urge incontinence can also be caused by an overactive bladder (OAB) - though it’s important to note that an overactive bladder does not always cause incontinence and is not itself considered a disease. OAB can be caused when the muscles in your bladder are too active.

Treatment options for urge incontinence can include biofeedback therapy, which seeks to give you greater awareness of your body’s physiological responses and help control the bladder muscle. Exercises to strengthen the pelvic floor muscles (i.e., Kegels) can help, too; while they won’t eliminate the urge, they can help ensure it doesn’t lead to a leak.

2. Stress Incontinence

Stress urinary incontinence (SUI) has nothing to do with emotional stress but is about physical exertion. This can be the obvious physical exertion of doing exercise. But it can also include bodily functions and involuntary reactions like coughing, sneezing, even laughing, and having sex.

When any of those exertions cause an involuntary loss of bladder control resulting in leakage of urine, it’s called stress urinary incontinence. And the cause of stress urinary incontinence is usually weakened muscles that become weaker when the body is experiencing the ‘stress’ of those exertions, so those muscles fail to hold in your pee.

Your pelvic floor muscles are, after all, just like any other muscle: They can be injured, damaged, or weak because of age and not getting enough exercise. Damage to the muscles of the bladder and urethra can happen to women due to childbirth or trauma from surgery (e.g., hysterectomy). And weakened muscles can happen because of aging (menopause) and lack of exercise. This is one of the reasons why Kegel exercises (pelvic floor muscle training) are so often recommended as a good practice for all women and, in particular, to help reduce stress urinary incontinence.

Written by Jane Flanagan — Updated on March 25, 2022.

We hope you found this post informative — but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.