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Suggest treatment for over-active bladder and urinary incontinence

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Posted on Thu, 14 May 2015
Question: I feel like I have an overactive bladder plus urinary overflow incontinence, but i want to get a doctor's opinion. I have a weak stream and can't fully empty my bladder. Although I never leak urine or wet my pants, but i feel as if whenever i drink alot of water at once, i feel urine is let out of my bladder too quickly and in small amounts, and it just sits in my urethra without feeling that need to pee. So when i go to the bathroom, some urine comes out. And 5 minutes later the same thing will happen, again and again until theres no more to come out. I've resorted to wearing adult daipers daily and it's ruining my life. I cant just be like every body else where they can just drink whatever amount they want, and just pee at once in one time, an hour or two later. What do I actually have? what can i do? Is it bladder stones? A weak kidney? Please help.
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Answered by Dr. Muhammad Sareer Khalil (1 hour later)
Brief Answer:
Workup needed to rule out common causes like UTI, Stones

Detailed Answer:
Hello and Welcome

I appreciate your concern

You described the condition accurately in terms of OAB i.e Overactive bladder and overflow incontinence. However in Overflow incontinence there is involuntary release of urine from an overloaded bladder. If the creatinine is in normal range then your kidneys are not weak. Uric acid and calcium levels in the blood should be measured. With such a presentation, the common causes need to be looked for first. These include UTIs, Urinary tract stones. Both of which can mimic the symptoms of an overactive bladder. An X ray KUB and Ultrasound abdomen/pelvis along with a Urine R/E ( Routine exam ) should be advised. If a small stone in the bladder is found, it is often accompanied by stranguria i.e where there is difficulty in micturition and the urine is passed drop by drop with pain and discomfort. Potassium citrate can be advised for 2 months if the stone or concretions are small i.e less than 5 mm. The Ultrasound can also measure and give approximate weight of the prostate, which can enlarge and cause OAB, nocturia as well as overflow incontinence. PSA levels should also be advised and if any enlargement is there alpha 1 blockers like tamsulosin can be started. Anti Muscarinic agents like tolterodine can limit the visits to the wash room and help in increasing the bladder capacity over long term if kegel exercises are also employed as part of bladder training. Cystometric studies can be advised if your urologist wants to confirm the clinical suspicions based on your history and physical exam.

Wishing you best of health

Thanks

Please consult your doctor/Urologist in this regard before deciding on any further course of action.

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2914 Questions

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Suggest treatment for over-active bladder and urinary incontinence

Brief Answer: Workup needed to rule out common causes like UTI, Stones Detailed Answer: Hello and Welcome I appreciate your concern You described the condition accurately in terms of OAB i.e Overactive bladder and overflow incontinence. However in Overflow incontinence there is involuntary release of urine from an overloaded bladder. If the creatinine is in normal range then your kidneys are not weak. Uric acid and calcium levels in the blood should be measured. With such a presentation, the common causes need to be looked for first. These include UTIs, Urinary tract stones. Both of which can mimic the symptoms of an overactive bladder. An X ray KUB and Ultrasound abdomen/pelvis along with a Urine R/E ( Routine exam ) should be advised. If a small stone in the bladder is found, it is often accompanied by stranguria i.e where there is difficulty in micturition and the urine is passed drop by drop with pain and discomfort. Potassium citrate can be advised for 2 months if the stone or concretions are small i.e less than 5 mm. The Ultrasound can also measure and give approximate weight of the prostate, which can enlarge and cause OAB, nocturia as well as overflow incontinence. PSA levels should also be advised and if any enlargement is there alpha 1 blockers like tamsulosin can be started. Anti Muscarinic agents like tolterodine can limit the visits to the wash room and help in increasing the bladder capacity over long term if kegel exercises are also employed as part of bladder training. Cystometric studies can be advised if your urologist wants to confirm the clinical suspicions based on your history and physical exam. Wishing you best of health Thanks Please consult your doctor/Urologist in this regard before deciding on any further course of action. Dr. M.S. Khalil