Leakage of urine associated with urinary retention.
- Bladder pressure
exceeds urethral pressure and urine leaks.
- Bladder fails to properly empty
due to over distention, pharmacological or neurological causes.
- chronic over distension
can stretch the bladder, reducing its ability to contract
- drugs can inhibit bladder contraction allowing it
- nerve damage from
diabetes or lower spinal cord injury block nerve transmission
- More common in men than women
- In men, over distention may be due to
chronic outlet obstruction from prostatic hyperplasia, prostatic carcinoma,
or urethral stricture.
- In women, over distention may due to
outlet obstruction from prolapse of
the anterior vaginal wall (cystocele), prolapse of the
posterior wall (rectocele), uterine prolapse, or
complications following pelvic surgery.
- Fecal impaction can also lead to urinary outlet obstruction
and chronic bladder distention
SIGNS & SYMPTOMS:
A large post void residual (PVR), and frequent or constant dribbling, and possible urgency
and frequency of
With overflow incontinence, the bladder often
remains quite full after voiding.
- Catheterization is to be avoided when possible
- Allow sufficient time for voiding.
- Instruct patient in double voiding
- Instruct patient in Crede's maneuver
- Review medications for anticholinergics and other meds which can worsen symptoms
- Alpha-adrenergic blockers including: doxazosin, prazosin, tamsulosin, and terazosin may be trialed to relax the musculature at the base of the urethra.
- Patient with abnormal PVR may require referral
to urologist or gynecologist
- Patient teaching for intermittent or indwelling catheter as ordered
- Patients resistant to medical treatment may require surgery