Diagnosis of Urinary Incontinence

If you are having a problem with incontinence, the first step is to see your health care provider. She or he can refer you to a urologist, a doctor who specializes in treating the urinary tract. Some urologists further specialize in the female urinary tract. Gynecologists and obstetricians specialize in the female reproductive tract and childbirth. A urogynecologist focuses on urological problems in women. Family practitioners and internists treat patients for all kinds of complaints. Any of these doctors may be able to help you.

To diagnose the problem, your health care provider will first ask you about your symptoms and for a complete medical history. Your provider should ask you about your overall health, any problems you are having, medications you are taking, surgeries you have had, pregnancy history, and past illnesses. You will also be asked about your bladder habits: how often you empty your bladder, how and when you leak urine, or when you have accidents.

Your provider will then do a physical exam to look for signs of any medical conditions that can cause incontinence, such as tumors that block the urinary tract, impacted stool, and poor reflexes that may be nerve-related.

A test may be done to figure out how much your bladder can hold and how well your bladder muscles function. For this test, you will be asked to drink plenty of fluids and urinate into a measuring pan, after which your provider will measure any urine that remains in the bladder. Your provider may also recommend other tests, including the :

• Stress test - You relax, then cough hard as the provider watches for loss of urine.
• Urinalysis - You give a urine sample that is then tested for signs of infection or other causes of incontinence.
• Blood tests - You give a blood sample, which is sent to a laboratory to test for substances related to the causes of incontinence.
• Ultrasound - Sound waves are used to take a picture of the kidneys, bladder, and urethra, so any problems in these areas that could cause incontinence can be seen.
• Cystoscopy - A thin tube with a tiny camera is placed inside the urethra to view the inside of the urethra and bladder.
• Urodynamics - Pressure in the bladder and the flow of urine are measured using special techniques.

You may be asked to keep a diary for a day or a week in order to record when you empty your bladder. This diary should include the times you urinate and the amounts of urine you produce. To measure your urine, you can use a special pan that fits over the toilet rim. These pans are available at drug stores or surgical supply stores.