When The Floodgates Open: What You Should Know About Potentially Deadly "Overflow Incontinence"

Thanks for tuning in to the Armor Men’s Health Hour Podcast, where we bring you the latest and greatest in urology care and the best urology humor out there. Today, Dr. Mistry answers a listener question about BPH and prostate issues. In his email, this listener--who has a wonderful sense of humor about his condition--explains his symptoms as "low capacity and frequent urgency" which lead to "overflow" (urinary leakage). He describes his bladder as a "steel tennis ball" that is small and unable to hold much urine. "Would shriveling up my prostate return any capacity or elasticity to my bladder? Any other ideas?" In answering this excellent question, Dr. Mistry differentiates between obstructive urinary symptoms, such as slow flow and incomplete emptying, and a "low capacity" bladder, which can be treated by stretching the bladder with medication. A different and potentially life-threatening issue is the patient who has a normal-sized bladder, but who is only able to empty a few ounces of it at a time. This situation may lead to "overflow incontinence,"  a condition so dangerous that it can cause kidney failure. While "shriveling up the prostate" might help a patient with overflow incontinence, they must be evaluated immediately to prevent kidney damage or failure. Regardless of the cause, serious leakage is something that we approach aggressively in men and women and which can be treated with a number of interventions, all of which can not only alleviate symptoms but also drastically improve the quality of life those affected by leakage have. If you or a loved one are experiencing any of the above symptoms or are concerned about your amount of urinary leakage, please give us a call today!

This episode was previously aired on 8.7.21. Don’t forget to like, subscribe, and share us with a friend! As always, be well!

Check our our award winning podcast!
https://blog.feedspot.com/sex_therapy_podcasts/

https://blog.feedspot.com/mens_health_podcasts/

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

We enjoy hearing from you! Email us at armormenshealth@gmail.comand we’ll answer your question in an upcoming episode!

Phone: (512) 238-0762

Email: Armormenshealth@gmail.com

Website: Armormenshealth.com

Our Locations:

Round Rock Office

970 Hester’s Crossing Road
 Suite 101
 Round Rock, TX 78681

South Austin Office

6501 South Congress
 Suite 1-103
 Austin, TX 78745

Lakeline Office

12505 Hymeadow Drive
 Suite 2C
 Austin, TX 78750

Dripping Springs Office

170 Benney Lane
 Suite 202
 Dripping Springs, TX 78620

Transcript

Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my cohost, Donna Lee.

Donna Lee: Hello, Dr. Mistry! How are you today?

Dr. Mistry: I'm doing excellent. Doing excellent. This is a...

Donna Lee: Are you sure? You look tired.

Dr. Mistry: This is a men's health show. We are brought to you by NAU Urology Specialists. That is the urology specialty clinic started in 2007. We are in Austin, Texas, which may sound weird because you know, this is a radio show.

Donna Lee: Other people in the world don't know where Austin, Texas is.

Dr. Mistry: But this show is also available as a podcast.

Donna Lee: For free.

Dr. Mistry: And we, we're so happy to have listeners from all over the country and even all over the world. That's why they call me Mr . Worldwide.

Donna Lee: Dr . Worldwide. Mr. Worldwide is Pit Bull.

Dr. Mistry: That's right. Oh, I'm sorry.

Donna Lee: Get it right. Wow.

Dr. Mistry: But, but I have a funny story. So this weekend I saw a cousin of mine who's a cardiologist in Birmingham, Alabama.

Donna Lee: Oh really?

Dr. Mistry: And he is, he is also Indian, as you would imagine my cousin might be. And so he was in his clinic and his nurse practitioner came up to him and she said, "I listened to this awesome podcast. Do you know this guy?" And he took that as to mean all brown people know each other kind of thing.

Donna Lee: Oh no.

Dr. Mistry: And it happened that it was his cousin.

Donna Lee: That's funny.

Dr. Mistry: It was very funny.

Donna Lee: He didn't know about the show?

Dr. Mistry: He couldn't believe it.

Donna Lee: How does your relative not know about the show?

Dr. Mistry: We are doing a terrible job of marketing the show. That that's all I can say. When my own family doesn't even know...

Donna Lee: Our family members don't know we have a show.

Dr. Mistry: Well, there you go.

Donna Lee: That's funny, though. So now he's listening.

Dr. Mistry: Now, I can't make fun of him.

Donna Lee: Well, you can.

Dr. Mistry: OK. Well, there you go.

Donna Lee: What's his name?

Dr. Mistry: His name is Dr. Munish Goyal.

Donna Lee: Not even the same name.

Dr. Mistry: No. Family, wedding. This, that, the other. Who knows? I think he took his wife's name.

Donna Lee: Is he...Oh, that would be not Indian-like. Is he, is he a nice guy? So we can't make fun of him?

Dr. Mistry: He's nice enough. He's only about 4'10".

Donna Lee: Oh, stop.

Dr. Mistry: He's the cardiologist who doesn't believe in drinking water.

Donna Lee: Okay. I don't know how to answer that.

Dr. Mistry: I don't either.

Donna Lee: What does that mean?

Dr. Mistry: I don't know.

Donna Lee: He likes sodas?

Dr. Mistry: But I do think--yes, he's a Diet Coke drinker.

Donna Lee: Mm, that was you.

Dr. Mistry: I think it maybe genetic.

Donna Lee: Mhmm, genetics.

Dr. Mistry: Your, your, your questions, your participation with our show, and of course listening regularly, subscribing to the podcast--these are things that really drive us to continue the show. We'd love to talk about any variety of men's health topics. If you have topics that you'd like us to talk about that may, don't, don't have to do with your ding-a-ling and yum-yums...

Donna Lee: Well, it should though, because that's our show.

Dr. Mistry: Yes. It's a big part of our show. But we can talk about other things as well.

Donna Lee: Nipples to the knees.

Dr. Mistry: And if you listen to other previous podcasts, you'll hear episodes on cardiology. We've had Dr. Declan Fleming, an amazing surgical oncologist, on the show. We've had some...

Donna Lee: He saved my mom's life in a way.

Dr. Mistry: Yeah, that's right. He did . I was there.

Donna Lee: That's right. No, that's right. You saved her, too.

Dr. Mistry: I operated on her, too.

Donna Lee: You also saved her life. OK, thank you. Thanks for that.

Dr. Mistry: That's silly. Now we've had Dr. Tripp Buckley talking about surgical ways to fix GERD. We have awesome orthopedic surgeons, just the top guys in town--in Austin, at least Tyler Goldberg. We've had...

Donna Lee: We had Dr. Eric Lough last week again.

Dr. Mistry: That's right. We've had people talking about the HERO. Hernias, esophageal surgery, reflux and obesity surgery--HEROs. That's what they call general surgeons.

Donna Lee: It's also a Mariah Carey song.

Dr. Mistry: Hero. So if you have questions, so that's what we want to hear. We're seeing patients in the clinic. We are a urology clinic, not just an entertainment powerhouse.

Donna Lee: I thought we were.

Dr. Mistry: Entertainment and marketing powerhouse with our different, different t-shirts. How do people get ahold of us and what's our number?

Donna Lee: You can call us at (512) 238-0762 during the week. You can also ask for me. Our website is armormenshealth.com, and easily enough, our web, our email address is armormenshealth@gmail.com, where you can send these incredible thoughtful questions. And we have a few.

Dr. Mistry: Let's go for it.

Donna Lee: So the first one has to do with BPH. I'd like to remind the listeners that you don't know the question. I just told somebody this the other day, and she was shocked. She said, "He doesn't know the question when you ask it? I listen to all the time. He sounds like he knows the question beforehand." I said he has no idea.

Dr. Mistry: Nipples to the knees, I know about it.

Donna Lee: Right? Yum-yums and ding-a-lings, not a surprise. But this is a surprise question for you. This guy caught me off guard cause he's funny in the email.

Dr. Mistry: Okay.

Donna Lee: He says, "I don't mean to brag, but though I'm only 68, I have the prostate of an 80 year old. I guess I'm an overachiever. Diagnosed with BPH and I'm on 0.8 milligrams a day of tamsulosin. I have low capacity and frequent urgency as if I have a steel tennis ball for a bladder." Oh my. " And yesterday my kidney sent a few more cc's of urine to my bladder, which was full, and the overflow ran down my legs. So now I think I've blown out my sphincters!" Exclamation marks. "But I'm finally the whiz kid my parents wanted!" Ba-dum-bum! Whichever, would shriveling up my prostate return any capacity or elasticity to my bladder? Any other ideas?" Question mark.

Dr. Mistry: What a great question. That's exactly what we want to hear.

Donna Lee: Love that guy.

Dr. Mistry: First of all, we're the comedians.

Donna Lee: Yeah, don't try to be funny, sir.

Dr. Mistry: Yeah, don't try to be funny, sir. So , an enlarged prostate can cause urgency and frequency, but the most common symptoms it's going to cause is going to be obstructive symptoms. So a slow flow, incomplete emptying, and it can also lead to recurrent urinary tract infections , an inability to completely empty the bladder causing retention, bladder stones.

Donna Lee: Sounds terrible.

Dr. Mistry: Now, if you have a very small capacity bladder and are frequently urinating, the one key question is are you emptying your bladder? So let's say you are emptying your bladder and you're going to the bathroom every hour. That means you have a small tin can, or a tin, tin, tennis ball?

Donna Lee: Tennis ball. Steel tennis ball.

Dr. Mistry: Steel tennis ball as a bladder, meaning that you're able to completely empty, and then it just fills up to just three ounces and you got to pee again. That person benefits not from 0.8 milligrams of tamsulosin. They need a medicine to stretch their bladder. So those are people that we do Botox for. We have that Axonics neuromodulator that we do for them. We do pelvic floor physical therapy, and then we have a hundred different kinds of meds.

Donna Lee: Right.

Dr. Mistry: So you need something to stretch your bladder out.

Donna Lee: A medicine can do that.

Dr. Mistry: Now there's another kind of person and that person, they have a 20 ounce bladder, but only empty two ounces out of it. So that guy keeps filling that extra two ounces. And so he goes from 20 to 18 of in his bladder. He doesn't fully empty. So that guy goes to the bathroom all the time, but he needs to, we need to find a way to empty his bladder. That guy benefits from quote unquote "shriveling up his prostate." And if he is leaking now, he may have something called overflow incontinence. And that is so dangerous that that is something that could lead to kidney failure and he should certainly be evaluated. So just this weekend on call, same thing I saw. We saw a guy who was in his early sixties, had a history of an enlarged prostate, started leaking, went for incontinence. You know, he was in floored kidney failure because his bladder, his bladder wasn't emptying and it was causing his kidneys not to be able to take urine to his bladder. So overflow incontinence can cause leakage for the guy who is not emptying, but the guy who really does have a steel tennis ball for a bladder, he could just be, his, his bladder could be so tight that it's just squeezing and getting rid of the, of the urine. So he's not at risk for renal failure or kidney failure, but he is somebody who we would consider at the, at the urgent end of the spectrum to treat. Because if you're a man out there and you're leaking or wearing a diaper, this is something that we would consider in urology something that we would really aggressively try to manage. If you're a woman and you're having to wear a full diaper because you can't get to the bathroom fast enough, you know, please stop living like that. Like we have lots of things that we can do to help make you feel better. A protective pad for the woman who leaks because she leaks a little bit when she's jumping, jumping off a curb or jumping on a trampoline, those things perhaps are a little harder to get you completely rid of all protective pads, but, but diapers in young women and diapers and men , these are things that we have lots of treatments for. And so it's, it saddens me that , that , that you're having this leakage problem because the tamsulosin 0.8 may not be the treatment choice for you.

Donna Lee: Hmm. Well, this thing made me.

Dr. Mistry: And if you are--he's, he's having a good time.

Donna Lee: He's having fun, but...

Dr. Mistry: And if you're out there and you're taking Flomaxes or two Tamsulosins for your enlarged prostate, you need to be aware that long-term use of these kinds of medicines can lead to chronic fatigue-like syndrome, lower blood pressure , dizziness when you're standing, it can cause retrograde ejaculation. And that's why , as a general rule, we try to take patients who are on long-term management for enlarged prostate with medicines and switch them over to some kind of surgical procedure, which could include, quote unquote, "shriveling up the prostate." And if you're out there with an enlarged prostate issue, in the past, we've discussed issues, we've discussed surgeries like Urolift, TURP, GreenLight. We've discussed Rezum, which is the, using the steam.

Donna Lee: The spa of the prostate.

Dr. Mistry: The spa for the prostate. In the future, we're going to talk about Aquablate. And of course we've talked about prostate artery embolization, which is a way of treating the prostate without going through your penis. So lots of different ways that we had to deal with it. We'd love to see you as a patient. Donna, how do people get a hold of us?

Donna Lee: That's right. You can call us about any of those procedures at (512) 238-0762. You can also ask very specific questions if you'd like to know more by emailing us at armormenshealth@gmail.com. I respond to those emails to let you know that we received it and Dr. Mistry and I will chat about it as a surprise on the show. Our podcasts are free wherever you listen to podcasts all over the world. And , yeah . Shoot us an email to armormenshealth@gmail.com. Thank you so much, Dr. Mistry. I know that you are ready to get onto the next.

Dr. Mistry wants to hear from you! Email questions to armormenshealth@gmail.com. We'll be right back with the Armor Men's Health Hour.