The Difference Between Stress and Overflow Incontinence

You many think all leaks were created equally embarrassing, but the truth is that your body has all sorts of different ways of telling you when something’s wrong or different- even in the form of accidental leaks. But what kinds of leaks are there, and what do they mean about our health? Let’s take a look into the symptoms and solutions of different kinds of bladder leaks.

Overflow Incontinence

One form of incontinence that can develop is called Overflow Incontinence. Individuals that have Overflow Incontinence cannot properly empty their bladder completely, allowing more urine to be held over periods of time and overflow into a leak. People that experience these leaks often do not feel the need or “urge” to urinate. Other symptoms of Overflow Incontinence include:

• A feeling of fullness in the bladder even after urination.
• Leakage of urine while sleeping.
• A urine stream that stops and restarts during urination.
• Difficulty urinating even while feeling the urge to urinate.

The cause of this disorder usually stems from weakened or damaged muscles that surround the bladder, making them unable to completely contract and squeeze the bladder. These muscles can be damaged from surgical procedures that disrupt the pelvic floor and surrounding tissue, or by diseases that impact the nerves like Parkinsons' Disease or Spina Bifida. A blockage could also be causing overflow incontinence, preventing the bladder from completely emptying and becoming too full. For men, an enlarged prostate can partially close off the urethra and lead to leaks while women may develop it after childbirth if the urethra becomes bent in the process. It is more commonly diagnosed in men, however. Both males and females may experience Overflow Incontinence if they develop a tumor, bladder stone, or scar tissue, or even severe constipation that interrupts the normal flow of urine.

Solutions

There are some options available for those suffering from Overflow Incontinence. Talk to your doctor as there is usually a larger health issue that is blocking the flow of urine behind the scenes. Men and women have slightly varying options due to the physical properties of the urinary tract and the root of the leaks. Both males and females may have to use a catheter. A catheter is a thin, flexible tube that allows urine to drain out. It is inserted into the bladder through the urethra. Patients can choose to have a catheter put in place and remain there, or choose an intermittent self-catheter that is changed several times a day to reduce their chances of infection. In addition, both women and men may have surgery to remove a tumor or other obstruction from the urinary tract that may be causing their leaks. Men have the option of medication if their Overflow Incontinence is caused by an enlarged prostate, to reduce the size and relieve some of the pressure that is put on the urinary tract.

Stress Urinary Incontinence

Stress Urinary Incontinence or SUI is a different kind of urinary incontinence. The leaks occur when you laugh, sneeze, cough, jump, or even lift something ⸺ that’s the “stress” that is put on your bladder or urinary tract. These leaks are involuntary, hard to predict, and can vary in size making them hard to prepare for. SUI is caused by the weakening of the pelvic floor muscles, nerves, and surrounding tissue, although most experts believe there are two types of SUI.

1. urethral hypermobility - the urethra shifts position due to an increase in abdominal pressure.
2. intrinsic sphincteric deficiency (ISD) - the sphincter doesn’t seal off effectively at your bladder.

While both men and women may develop SUI, women are far more likely. This is due to a couple of reasons. Women's and men's urethras are different lengths, with women's being shorter and more susceptible to damage. In addition to physical differences, women who have given birth vaginally are more likely to damage and weaken the pelvic floor during delivery. In fact, after their first delivery ⅓ of mothers reported SUI symptoms, and the number grew with subsequent births. Developing SUI post-child-bearing years is also common. Women going through menopause slow down the production of estrogen, which lines and supports the urethra. There are other causes and risk factors that may lead to developing light bladder leaks, regardless of gender or age:

• High-impact activities like running, cycling, or gymnastics may weaken the pelvic floor over time.
• Smoking increases pressure and stress on the urinary tract and bladder with coughing and may weaken it over time.
• Surgeries that involve the pelvic floor muscles may damage or weaken them post-surgery.
• Being overweight also adds pressure and stress to the urinary tract, leading to light bladder leaks.

Solutions

There are options for both women and men to deal with their SUI and help them regain confidence in day-to-day life. Incontinence Products - There are pads, liners, and undergarments made for both women and men experiencing light bladder leaks. The downfalls? These products are usually not reusable, can be bulky and uncomfortable, and have to be changed to avoid odor or infection. Kegels - These are exercises meant to strengthen the pelvic floor muscles that control the flow of urine. For a step-by-step guide, check out our blog post. Surgery - Some may find that the only solution to help reduce their leaks is to have a surgical procedure done, however, the FDA has ordered the stop of production and sale of mesh slings for this type of surgery.

Revive™

Women also now have the option for an over-the-counter bladder support device called Revive™. Revive is a small, flexible, pessary device that is inserted to reduce bladder leaks for up to 12 hours a day. Available at drugstores and retailers nationwide, the device is easy to use, clean, and reuse for up to a month of use. Find a retailer that carries Revive near you with our store finder!