Overflow incontinence is leakage due to incomplete bladder emptying; a common urodynamic finding is high post-void residual with detrusor underactivity or outlet obstruction. Which statement best describes overflow incontinence and its typical finding?

• A. Leakage due to detrusor overactivity with high voiding pressures.
• B. Leakage associated with a sudden urge to void.
• C. Leakage due to incomplete bladder emptying.
• D. Leakage due to incomplete bladder emptying with high post-void residual and detrusor underactivity or outlet obstruction.

Answer: (D)

Overflow incontinence occurs when the bladder cannot empty completely, so urine leaks as it overfills. A key finding is a high post-void residual volume, indicating incomplete emptying. This leakage typically arises from detrusor underactivity (the bladder muscle isn’t contracting well) or from bladder outlet obstruction that prevents complete emptiness. Therefore, the statement that best captures overflow incontinence describes leakage due to incomplete bladder emptying, with a high post-void residual and underlying detrusor underactivity or outlet obstruction.

Descriptions of leakage due to detrusor overactivity with high voiding pressures or leakage associated with a sudden urge point to urge incontinence, not overflow.