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Overflow Incontinence--Part IV of V

Sonya Lytwynec, RegN, BScN,
Hassan Razvi, MD, FRCSC,
Southwestern Ontario Regional Geriatric Program: Continence Outreach

Overflow urinary incontinence is one of five types of incontinence.1 The assessment and therapeutic interventions associated with overflow incontinence are reviewed in the fourth article of a five-part series on urinary incontinence. The first article in this series provided an overview of the prevalence, types, and treatment of incontinence in the frail elderly.

Overflow incontinence is defined as the involuntary loss of urine associated with over-distension of the bladder.2 It is reported to comprise up to 30% of diagnoses in a geriatric continence clinic.3 Aging is associated with several physiologic and anatomic changes to the urinary tract which may predispose the older person to overflow incontinence. Both bladder outlet obstruction and detrusor muscle weakness may manifest alone or in combination as overflow incontinence. It has been estimated that up to 60% of men between 70 and 87 years of age develop clinical symptoms of benign prostatic hypertrophy (BPH).1 BPH is the most common cause of voiding dysfunction in elderly males and may first present as urinary retention and overflow incontinence. Overflow incontinence occurs less often in women, but may develop following pelvic surgery or as a result of pelvic organ prolapse.