Urinary Incontinence

Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:

• How often do you urinate?
• Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
• How long have you been experiencing incontinence?

These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, it’s important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.

There are also several specific tests that your provider might do to diagnose incontinence, including:

• Physical exam: Your healthcare provider will typically do a physical exam early in the diagnosis process. During this exam, your provider will look for any physical reason that could be causing your incontinence. This could include doing a pelvic exam if you’re a woman or checking the size of a man’s prostate.
• Urine samples: Your provider may take samples of your urine to test for infections or blood. Testing your urine is also called urinalysis.
• An ultrasound of your bladder: An ultrasound is a painless test that uses sound waves to create an image of your internal organs. This imaging test will allow your provider to look at the contents of your bladder and assess the emptying ability of your bladder in a non-invasive way.
• Stress test: During this test, your provider will ask you to cough to see if any urine leaks from this action. If you’ve noticed leakage during other activities, like running or jumping, your provider may ask you to repeat those actions to see if you have a leakage issue.
• Cystoscopy: A cystoscope is a thin flexible tube with a camera on the end that can be inserted into your urethra and bladder to get a close look at the inside of your urinary tract. This tool allows your provider to see a lot of detail inside your body.
• Urodynamic testing: This testing involves several tests that check how much your bladder can hold and how well your urethral sphincter muscle (the muscle that holds your urethra shut) is working. One part of this testing may involve inserting a tube into your bladder that will fill the bladder up with fluid. This checks how much your bladder can actually hold.
• Pad test: Your provider may give you a pad to wear, which will catch any leaked urine. At the end of the test, this pad will be checked to see how much urine you lost.

While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. You’ll then bring this journal with you to your appointment and talk about it with your provider.

When should I see a doctor about incontinence?

It’s important to know that incontinence can be treated. Many people believe that it’s something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.