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Tests and diagnosis

By Mayo Clinic staff

During a basic diagnostic work-up, your doctor looks for clues that may also indicate contributing factors. The exam will include:

  • A medical history
  • A complete physical examination with particular focus on your abdomen and genitals
  • A urine sample to test for infection, traces of blood or other abnormalities
  • A neurological exam to identify sensory problems
  • A urinary stress test, in which the doctor observes urine loss when you cough or bear down

Specialized tests
Your doctor may order urodynamic tests, which are used to assess the function of your bladder. Common tests include:

  • Measurements of postvoid residual urine. When you urinate or experience urinary incontinence, your bladder may not empty completely. To measure residual urine after you have voided, a thin tube (catheter) is passed through the urethra and into your bladder. The catheter drains the remaining urine, which can then be measured. Alternatively, a specialist may use an ultrasound scan, which translates sound waves into an image of your bladder and its contents.
  • Cystometry. Cystometry measures pressure in your bladder and in the surrounding region during bladder filling. A catheter is used to fill your bladder slowly with warm water. This procedure, when combined with a voiding study, tells whether the urinary sphincter (connecting the urethra to the bladder) exerts enough pressure to keep the urethra closed as bladder pressure rises.
  • Video urodynamics. These procedures use either X-ray or ultrasound waves to create pictures of your bladder as it's filling and emptying. Warm water mixed with a dye that shows up on X-rays is gradually instilled in your bladder via a catheter while the images are recorded. When your bladder is full, the imaging continues as you urinate to empty your bladder. This test is often combined with cystometry.

Your doctor will review the results of these tests with you and suggest a treatment strategy.

Treatments and drugs Preparing for your appointment

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  • Urinary incontinence
References
  1. DuBeau CE. Clinical presentation and diagnosis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2008.
  2. DuBeau CE. Patient information: Urinary incontinence. http://www.uptodate.com/patients/content/topic.do?topicKey=~/0j/LeBKevVnHo. Accessed Sept. 9, 2008.
  3. Urodynamic testing. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/urodynamic/index.htm. Accessed Sept. 9, 2008.
  4. Norton P, et al. Urinary incontinence in women. The Lancet. 2006;367(9504):57-67.
  5. Holroyd-Leduc JM, et al. Management of urinary incontinence in women: Scientific review. Journal of the American Medical Association. 2004;291(8):986-995.
  6. Norton PA. Female urinary incontinence: Epidemiology and evaluation. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:870-876.
  7. DuBeau CE. Patient information: Urinary incontinence treatments. http://www.uptodate.com/patients/content/topic.do?topicKey=~aup1.o0ho/j5Wk. Accessed Sept. 9, 2008.
  8. Baharak A, et al. Nonsurgical management of urinary incontinence and overactive bladder. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:890-899.
  9. Rogers RG. Urinary stress incontinence in women. The New England Journal of Medicine. 2008;358(10):1029-1036.
  10. Nager CW, et al. Operative management of urinary incontinence. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:877-889.
  11. Costa P, et al. Advancing the treatment of stress urinary incontinence. BJU International. 2006;97(5):911-915.
  12. Khan F, et al. Surgical treatment of stress urinary incontinence in women. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2008.
  13. Urodynamic testing. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/uimen/index.htm. Sept. 9, 2008.
  14. Rapp DE, et al. Surgical technique using AdVance sling placement in the treatment of post-prostatectomy urinary incontinence. International Brazilian Journal of Urology. 2007;33:231-237.
  15. Wolter CE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 6, 2008.

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