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Urology/overflow incontinence

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Question
I'm a 61 yr old male with a slightly enlarged prostate, the urologist said it was normal size for my age. Lately I notice dribbling, not just after urination, but other times as well, just a few drops. I read that "Overflow incontinence is a form of urinary incontinence, characterized by the involuntary release of urine from an overly full urinary bladder, often in the absence of any urge to urinate."

If the bladder has urine that needs to be released, why isn't there the urge to urinate?  Thanks

Answer
My sub-specialty practice does not include BPH treatment or neurogenic bladder dysfunction evaluation-treatment, although I do treat male incontinence secondary to sphincter damage from prostate cancer treatment with surgery to place artificial sphincters.  However, I am familiar with this condition in general.  When there is an involuntary loss of urine, it can come from the bladder, or it can come from the urethra.  After urination, if there is any urine retained in the urethra (which courses under the scrotum and through the prostate, this can later dribble out without an associated bladder sensation.  Also, men with certain neurological conditions may have a sensory loss involving their bladder or have involuntary bladder neck contractions.  Overflow incontinence is a bad thing.  In general, this happens with severe obstruction or a bladder that does not contract.  The "good news" is that if this is suspected, it can be evaluated with zero risks.  Immediately after urination, an ultrasound probe can be placed over the bladder, and a dedicated machine will calculate the residual urine.  This test is totally non invasive, painless, and takes less than 60 seconds.  This is a common procedure done in the offices of Urologists.  If the residual is low, this would suggest no overflow incontinence.  

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Joel Gelman, M.D.

Expertise

Urethral Stricture Disease, Peyronie's Disease and disorders of penile curvature, Erectile Dysfunction with a focus on penile implant surgery, Male Incontinence, Hypospadias

Experience

Dr. Gelman is a Board Certified Fellowship Trained expert in Male Reconstructive Urology and the Director of the Center for Reconstructive Urology in the Department of Urology at UC, Irvine Medical Center.

Organizations
American Urologic Association Society of GU Reconstructive Surgeons (Board of Directors) International Sexual Medicine Society Western Section, Americal Urological Association

Publications
Journal of Urology Urology Journal of Endourology

Education/Credentials
Residency in Urology, UCLA, completed 1995 Fellowship in GU Reconstruction, Devine Center, completed 1997

Past/Present Clients
The Center for Reconstructive Urology is a regional, national, and international Tertiary Referral Center for urethral stricture disease, penile curvature, erectile dysfunction, male incontinence, and other surgical disorders of the male urethra and penis. Patients have travelled from 24 different states and other countries to receive care at the Center for Reconstructive Urology. More information can be found at http://www.centerforreconstructiveurology.org

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