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Tests and diagnosis
By Mayo Clinic staffDuring a basic diagnostic work-up, your doctor looks for clues that may also indicate contributing factors. The exam will likely 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.
- Measuring bladder pressure. 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 muscle that connects the urethra to the bladder (urinary sphincter) exerts enough pressure to keep the urethra closed as bladder pressure rises.
- Creating images of the bladder as it functions. Video urodynamics 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.
You and your doctor can review the results of these tests and decide on a treatment strategy.
References
- Fong E, et al. Urinary incontinence. Primary Care Clinics in Office Practice. 2010;37:599.
- Nitti VW, et al. Urinary incontinence: Epidemiology, pathophysiology, evaluation, and management overview. In: Wein AJ. Campbell-Walsh Urology. 9th ed. Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/214316744-4/1038180294/1445/63.html#4-u1.0-B978-0-7216-0798-6..50062-5--cesec2_4438. Accessed Aug. 17, 2010.
- DuBeau C. Clinical presentation and diagnosis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- DuBeau C. Epidemiology, risk factors, and pathogenesis of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- DuBeau C. Treatment of urinary incontinence. http://www.uptodate.com/home/index.html. Accessed Aug. 17, 2010.
- Urinary incontinence. WomensHealth.gov. http://www.womenshealth.gov/faq/urinary-incontinence.cfm. Accessed Aug. 17, 2010.
- Urinary incontinence in women. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.htm. Accessed Aug. 17, 2010.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 19, 2010.
- Clinician training & resources FAQ. FemSoft Insert. http://www.femsofttraining.com. Accessed Sept. 28, 2010.
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