Proper diagnosis essential to treating incontinence
Urinary incontinence is not something that you have to live with and it is not something that is going to go away on its own. There are many options available to treat your bladder leakage and improve your quality of life.
Most physicians find it best to recommend the most conservative, non-invasive or minimally invasive treatment options for bladder leakage first—those offering proven benefits with few or no side effects. If these treatment options do not provide relief, they then move on to medications or surgical procedures that may have greater risks, side effects and recovery time.
The first step is to diagnose the specific type of incontinence. Your doctor will likely start with a complete history and physical exam.
Typical First Steps
- Medical History
- Urinalysis: To check for a urinary tract infection, blood or other abnormalities.
- Questionnaires: To identify symptoms that you are experiencing.
- Bladder Diary: You will detail, for several days, how much you drink, urinate, how often you have urges to urinate and leakage episodes.
Tests to identify the cause of incontinence
- Ultrasound Imagery: Show how the bladder and urethra change position during urination, coughing or other activities.
- Bladder Stress Test: Checks for stress incontinence by having you demonstrate, with a full bladder, coughing and other activities that increase stress upon the bladder.
- Post-void residual measurement: You will urinate into a container in order to measure urine output. Your doctor will then check the amount of urine leftover in your bladder using a catheter or ultrasound test.
- Cystogram: Your doctor inserts a thin flexible catheter (tube) into your urethra and bladder and injects a special dye. You will be asked to urinate and expel this fluid. X-ray images of your bladder assist in revealing problems with the urinary tract.
- Cystoscopy: Your doctor inserts a thin tube with a small lens into your urethra to check for abnormalities in the urinary tract.
- MRI scan: This may show problems that cannot be seen with other imaging methods.
- Urodynamic Testing: A doctor or nurse inserts a small catheter (tube) into your urethra and bladder and fill with water. A pressure monitor measures and records the pressure within your bladder. Urodynamic testing assists in measuring your bladder strength and urinary sphincter health. Urodynamic testing assists in identifying the type of incontinence you are experiencing.