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Tests and diagnosis

By Mayo Clinic staff

Common tests and processes for urinary incontinence include:

  • Bladder diary. Your doctor may ask you to keep a bladder diary for several days. You record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
  • Urinalysis. A sample of your urine is sent to a laboratory, where it's checked for signs of infection, traces of blood or other abnormalities.
  • Blood test. Your doctor may have a sample of your blood drawn and sent to a laboratory for analysis. Your blood is checked for various chemicals and substances related to causes of incontinence.

Specialized testing
If further information is needed, you may undergo additional testing, including:

  • Postvoid residual (PVR) measurement. For the procedure, you're asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of leftover (residual) urine in your bladder using a catheter or ultrasound. A catheter is a thin, soft tube that's inserted into your urethra and bladder to drain any remaining urine. For an ultrasound, a wand-like device is placed over your abdomen. Using sound waves and a computer, the ultrasound creates an image of your bladder. A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.
  • Pelvic ultrasound. Ultrasound also may be used to view other parts of your urinary tract or genitals to check for abnormalities.
  • Stress test. For this test, you're asked to cough vigorously or bear down as your doctor examines you and watches for loss of urine.
  • Urodynamic testing. These tests measure pressure in your bladder when it's at rest and when it's filling. A doctor or nurse inserts a catheter into your urethra and bladder to fill your bladder with water. Meanwhile, a pressure monitor measures and records the pressure within your bladder. This test helps measure your bladder strength and urinary sphincter health.
  • Cystogram. In this X-ray of your bladder, a catheter is inserted into your urethra and bladder. Through the catheter, your doctor injects a fluid containing a special dye. As you urinate and expel this fluid, images show up on a series of X-rays. These images help reveal problems with your urinary tract.
  • Cystoscopy. A thin tube with a tiny lens (cystoscope) is inserted into your urethra. This way, your doctor can check for — and potentially remove — abnormalities in your urinary tract.
Treatments and drugs Preparing for your appointment
References
  1. Urge urinary incontinence/overactive bladder. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/urge-incontinence. Accessed May 16, 2009.
  2. Non-surgical treatment for female stress urinary incontinence. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/non-surgical-treatment-for-female-stress-urinary-incontinence. Accessed May 16, 2009.
  3. DuBeau CE. Treatment of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed May 16, 2009.
  4. Herbruck LF. Stress urinary incontinence: An overview of diagnosis and treatment options. Urology Nursing. 2008;28:186.
  5. Cartwright R, et al. Current management of overactive bladder. Current Opinion in Obstetrics and Gynecology. 2008;20:489.
  6. Urinary incontinence. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/urinary.htm. Accessed May 16, 2009.
  7. Seeking treatment. National Association for Continence. http://www.nafc.org/seeking-treatment. Accessed May 16, 2009.
  8. Interstitial cystitis/Painful bladder syndrome. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis. Accessed May 16, 2009.
  9. How medications affect your bladder. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/urge-incontinence/medications. Accessed May 16, 2009.
  10. Facts and statistics. National Association for Continence. http://www.nafc.org/media/media-kit/facts-statistics. Accessed May 16, 2009.
  11. Urinary incontinence: What every man should know. National Association for Continence. http://www.nafc.org/bladder-bowel-health/what-is-incontinence/what-every-man-should-know. Accessed May 16, 2009.
  12. What I need to know about prostate problems. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/prostate_ez/#prostatitis. Accessed May 16, 2009.
  13. Urinary incontinence in women. National Association for Continence. http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.htm#evaluation. Accessed May 16, 2009.
  14. Cystoscopy and ureteroscopy. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy. Accessed May 16, 2009.
  15. Peterson JA. Minimize urinary incontinence: Maximize physical activity in women. Urology Nursing. 2008;28:351.
  16. Karsenty G, et al. Botulinum toxin A (Botox) intradetrusor injections in adults with neurogenic detrusor overactivity/neurogenic overactive bladder: A systematic literature review. European Association of Urology. 2008;53:275.
  17. Artificial urinary sphincter. National Association for Continence. http://www.nafc.org/uploads///pdf/educational%20brochures/OnlineAUS.pdf. Accessed May 17, 2009.
  18. Surgery for urinary incontinence. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp166.cfm. Accessed May 17, 2009.
  19. Surgical treatment for female stress urinary incontinence. National Association for Continence. http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence. Accessed May 17, 2009.
  20. Khan F, et al. Surgical treatment of stress urinary incontinence in women. http://www.uptodate.com/home/index.html. Accessed May 17, 2009.
  21. Cespedes RD. Is injection therapy for stress urinary incontinence dead? No. Urology. 2009;73:11.
  22. Christofi N, et al. An evidence-based approach to lifestyle interventions in urogynaecology. Menopause International. 2007;13:154.

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June 27, 2009

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