Diagnosis | Urinary Incontinence | Canadian Continence

Diagnosis

As you can see, there are many different types of, and possible causes for your incontinence. The first step is to see your doctor for a complete exam. He or she will ask you a series of questions (see the list of sample questions on the right).

Before your appointment, take some time to look them over and write down any information you think may be useful. Answer the questionnaire on page 11 and bring a copy to your doctor — the more information he/she has about your symptoms, the better equipped he/she will be to help.

Keeping a bladder diary (also called a voiding record) for a couple of days is another great way to help your doctor understand your symptoms. Use it to record what you drink, how often and how much you urinate over the course of two days. You’ll find an example of a bladder diary on page 12.

During the visit, your doctor will perform a thorough physical exam of your abdomen and genitals. He/she will look for things like a urinary tract infection or bladder infection, a mass or compacted stool. He/she may also do or order the following simple tests:

Stress test: You’ll be asked to cough or bear down while the doctor checks for urine loss.

Urinalysis: A sample of your urine is sent to the lab to check for signs of infection, blood or other abnormalities.

Most often, these simple tests will be enough for your doctor to identify the type of incontinence you have and recommend some form of treatment. In some cases however, he or she may refer you to a specialist (see “Meet the experts” on page 28) for additional tests. These can include:

  • Flow test and postvoid residual measurement (PVR) — This test is done to see if you have problems emptying your bladder. You will be asked to urinate into a special measuring container (so the doctor can check how fast you empty your bladder and how much you urinate). He or she will then measure the amount of urine left in your bladder, either by ultrasound or by placing a small tube (catheter) into the bladder.
  • Urodynamic testing — Using a catheter, this test measures the pressure in your bladder when it’s empty and as it fills, giving information about how the bladder and urethra are working. Some people find these tests embarrassing and uncomfortable, but they may help determine the best course of treatment for your symptoms.
  • Cystocopy — A tube with a tiny lens at the end of it is inserted through the urethra and into the bladder, so your doctor can check for and possibly remove abnormalities in your urinary tract.
  • Pelvic ultrasound — Like the ultrasounds done on pregnant women, this test lets the doctor get a better look at your urinary tract.
  • Voiding cystogram (rare) — During this test, a special dye is injected into the urethra and bladder. You will then be asked to urinate. Because of the dye, the flow of urine through the lower urinary tract can be seen by x-ray, allowing your doctor to look for problems with your urethra.
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