It appears that you have overflow incontinence associated with benign prostatic hypertrophy. The initial treatment of choice is alpha-adrenergic antagonists such as Flomax (tamsulosin) that act by relaxing smooth muscles around the bladder neck to help increase urine flow.
Saw palmetto is a herbal drug extracted from the saw palmetto fruit. It has been used for centuries in herbal and alternative medical practices. It has been believed to be effective in treating gynecologic and urologic issues such as menstrual discomfort and infertility in women as well as reduce the incontinence associated with benign prostatic hypertrophy.
However, saw palmetto has not been scientifically proven to improve urinary flow. In a 2006 trial published in the New England Journal of Medicine, 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia were treated with saw palmetto extract (160 mg twice a day) or placebo. The authors found that there was no significant difference between the saw palmetto and placebo groups in the change in maximal urinary flow rate, prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study.
Besides allergic reactions, saw palmetto has two notable side effects associated with its use. Saw palmetto has been associated with an increased risk of bleeding. Patients who are on blood thinners like warfarin (coumadin) should be especially cautious and all users should stop two weeks prior to surgical procedures. Although unverified, saw palmetto has been reported to increase heart disease progression especially in those who have an existing history of heart disease, past heart attacks, diabetes, and coronary stents.