Overflow incontinence occurs due to an outlet obstruction that then “overflows” to cause incontinence. Benign prostatic hypertrophy (BPH) is a leading cause because the enlarged prostate pushes against and pinches off the urethra as it passes through the prostate. However, other conditions can also cause the symptoms, which include:  Increased urinary frequency Urinary hesitancy (trouble urinating despite needing to) Nocturia (going to the restroom at night a lot) Weakened urinary stream Recurrent urinary tract infections (UTIs) Urinary incontinence Occasion urinary retention (cannot urinate at all) While BPH is one of the most common causes of overflow incontinence, it’s not the only cause. See your doctor and describe your symptoms in order to help him or her determine the correct diagnosis for your specific condition. A tumor in the bladder or prostate can also lead to overflow incontinence, so your doctor will likely perform a screening to rule out these possibilities. Tests will include a prostate-specific antigen (PSA) test of your blood, a digital rectal exam (DTE) to feel for prostate abnormalities, and/or a cystoscopy (a tube inserted into the bladder via the urethra to check for a tumor). If the doctor finds a tumor in any of these instances, he or she will like perform a biopsy to determine whether it is benign or malignant. During your appointment, your doctor will also ask about any medications you take since some of them can lead to overflow incontinence as a side effect. Diuretics for cardiac problems, sedatives, and muscle relaxants are common medications that can lead to incontinence issues. Some antidepressants, sleeping pills, and high blood pressure medications have also been linked to overflow incontinence.  Since many of these medications are prescriptions to help with much more serious issues than just incontinence, never stop taking a prescribed medication unless under the guidance of your doctor. Though not medications, excess consumption of coffee, tea, alcohol, and vitamins B or C can also lead to overflow incontinence. Your doctor can run a blood panel to test if your diet is too high in B and/or C vitamins. For mild-to-moderate BPH symptoms, there are several prescription medications that are available for symptom control such as:  Alpha blockers such as Hytrin, which does not actually work to shrink the size of the prostate, but will relieve symptoms within a few weeks 5-alpha-reductase inhibitors such as Avodart work to reduce the size of the prostate but may not improve symptoms for up to six months Cialis, which although originally marketed for erectile dysfunction (ED) improves symptoms of BPH as well Your doctor may prescribe a combination of Avodart and Hytrin to have both advantages. This is common, safe, and effective approach to control overflow incontinence. A transurethral resection of the prostate (TURP) is the go-to procedure for relieving lower urinary tract outlet obstruction due to enlargement of the prostate blocking of the bladder from emptying.This technique uses an endoscope to enter the urethra and clear or ablate the excessive prostate tissue encroaching on the urethra.  The procedure can use anything from a laser or microwave to needle ablation or photoselective vaporization. It is minimally invasive and done as an office procedure in many cases.  It may require a secondary operation in a decade due to tissue regrowth.
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