To diagnose the problem, your doctor will first ask about symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence. Other obvious factors that can help define the problem include straining and discomfort, use of drugs, recent surgery, and illness. If your medical history does not define the problem, it will at least suggest which tests are needed.
Your doctor will physically examine you for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.
Your doctor will measure your bladder capacity and residual urine for evidence of poorly functioning bladder muscles. To do this, you will drink plenty of fluids and urinate into a measuring pan, after which the doctor will measure any urine remaining in the bladder. Your doctor may also recommend:
- Stress test--You relax, then cough vigorously as the doctor watches for loss of urine.
- Urinalysis--Urine is tested for evidence of infection, urinary stones, or other contributing causes.
- Blood tests--Blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
- Ultrasound--Sound waves are used to "see" the kidneys, ureters, bladder, and urethra.
- Cystoscopy--A thin tube with a tiny camera is inserted in the urethra and used to see the urethra and bladder.
- Urodynamics--Various techniques measure pressure in the bladder and the flow of urine.
Your doctor may ask you to keep a diary to record when you void for a day or more, up to a week. This diary should note 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. h3]The Types of Urinary Incontinence
Stress Incontinence: Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising)
Urge Incontinence: Leakage of large amounts of urine at unexpected times, including during sleep
Functional Incontinence: Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet
Overflow Incontinence: Unexpected leakage of small amounts of urine because of a full bladder
Mixed Incontinence: Usually the occurrence of stress and urge incontinence together
Transient Incontinence: Leakage that occurs temporarily because of a condition that will pass (infection, medication)
Reprinted from the National Kidney and Urologic Diseases Information Clearinghouse
