Upon your initial visit, a physician will review your complete medical history and will perform a pelvic exam. You will also be asked how much liquid you drink daily, and how often and how much you urinate and leak. It may help to keep track of these things for 3 or 4 days before you see your doctor.
The physician will examine you and may need to perform various tests and exams to determine the cause of your bladder control problem. If the doctor thinks it may be caused by more than one problem, you will likely have more tests.
To diagnose the cause of your urinary incontinence, our physicians may need to perform one or more of the following tests:
A sample of your urine will be taken for review by a lab.
For the bladder stress test, your doctor will insert fluid into your bladder and then check for leaking after asking you to cough.
The Bonney test is similar to the bladder stress test except the bladder neck is lifted slightly with an instrument while the bladder stress is applied.
A pad test can show how much urine you are passing and how often throughout the day. This is helpful when incontinence cannot be triggered during an exam.
Urodynamic testing is generally done only if surgery is being considered or if treatment has not worked for you and you need to know more about the cause. It provides a more advanced way to check bladder function. Urodynamic testing may be done if the above tests do not give an answer to why you have leakage of urine or your health professional suspects that you have mixed incontinence with more than one cause. The actual tests done in urodynamic testing often vary. They may include:
(cystometrography, uroflowmetry), which is a series of tests to measure bladder pressure at different levels of fullness.
Leak point pressure (LPP), which measures weakness in the muscle that holds back urine (sphincter).
Maximum urethral closure pressure (MUCP), which measures the pressure keeping the urethra closed naturally.
Postvoid residual (PVR) measurements and X-rays or ultrasound.
These are used to examine changes in the position of the bladder and urethra during urination, coughing, or straining.
If the cause of incontinence is not identified by the above tests, more extensive tests may be needed.
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