Exams and Tests
The first steps your health professional will take to learn the
cause of your
urinary incontinence are a
medical history and a physical examination. The
physical exam will include examination of the penis, the prostate, and the
nervous system. The history and exam, along with routine diagnostic tests such
as a urinalysis, often provide enough information to determine the cause of the
incontinence and enable your health professional to start treatment.
Your health professional may ask you to keep a
voiding log, which is a record of the amount of
liquids you drink and how much and how often you urinate.
Tests that may be done to determine the type and cause of your
urinary incontinence include:
- Urinalysis and
urine culture, which may be done to learn whether a
urinary tract infection (UTI) or
prostatitis are present or whether there is blood or
sugar in your urine.
- Cough test to check for urine leakage while
coughing.
- Urodynamic tests, which could include tests to look
for hesitancy or interruptions of your urine flow, to measure the volume of
urine left in your bladder after urination (post-void residual), and to measure
how much urine in the bladder causes you to have a strong urge to urinate. The
actual tests done vary from person to person. Urodynamic testing may include:
- Uroflowmetry.
The uroflowmetry test measures the rate of urine flow during urination. During
the test, a flow curve will be charted to determine the peak flow rate. A low
peak flow rate may be suggestive of an obstruction or a weak bladder causing
the incontinence.
- Pressure flow studies, which measure pressures
produced in the bladder as the flow changes. Pressure studies may help
distinguish between urinary symptoms caused by obstruction and those caused by
a problem affecting the bladder muscles or nerves. This test is often used when
the cause of a man's symptoms is uncertain.
- Residual urine determination. Your health
professional may measure your post-void residual volume by inserting a thin
tube (catheter) into your bladder or by using a bladder
ultrasound scan immediately after you have urinated.
- Cystometrogram (CMG). This test evaluates your
bladder's ability to store and release urine.
- Electromyogram (EMG), which is used to record the
electrical activity of muscles.
Your health professional may conduct a cystoscopic exam (a test
that allows your health professional to see inside the urinary tract) to rule
out other causes of incontinence.
Further tests may be required if initial treatment for incontinence
has failed. Other tests may also be needed if you have had previous prostate
surgery,
radiation therapy, or frequent
urinary tract infections or if a
catheter cannot be easily placed into your
bladder.
Tests such as cystourethrogram, an X-ray taken of your bladder and
urethra while you are urinating, are not often used to evaluate incontinence,
but they may be helpful. If your health professional wants to do one of these
tests, ask whether the test is necessary to diagnose your type of
incontinence.