Stress Incontinence Diagnosis

Stress incontinence diagnosis most successfully when an accurate medical history, current voiding diary, urodynamic study, and a post void residual ultrasound is analyzed. First our doctors will ask you about your medical history and your urination patterns. They may ask you to keep a voiding diary for about three to four days to explain how often you urinate, what the urine color and flow are like, if and when you leak urine, what fluids you drank, and any other symptoms you may have. This information will provide clues and answers that our doctors can use to make an accurate diagnosis and determine the cause of your incontinence.

Stress incontinence diagnosis will also involve a physical examination. This may include a pelvic exam including a rectal examination or a vaginal examination. Doctors may be able to feel for a prolapsed bladder, or dropped bladder into the vagina or urethra. Through an exam doctors will also be able to feel for an enlarged prostate that could form a urethral stricture and restrict urine flow.

During an exam, you may have to cough while standing up to see if you have stress incontinence that would make you urinate involuntarily. In addition, you may be asked to have a urinalysis and urine culture to test for cystitis, or an inflamed bladder, that could cause a bladder infection, or urinary tract infection. Our doctors may also ask you to wear a pad to see how much urine you are leaking throughout the day.

A urodynamic study is generally done if non-surgical treatment has not been successful and if surgery is being considered. This study can provide more information about the cause of your incontinence, as well as help determine if you have mixed incontinence, by further testing bladder function. Some tests of a urodynamic study can include a voiding cystometry that measures the bladder pressure at different levels of fullness as well as the strength of the pelvic muscles. It can also include a post void bladder scan to test post void residual urine measurement (PVR measurement) to see how much urine is left in the bladder after urinating. Other tests include a bladder scan or bladder ultrasound to check for the volume of fluid in your bladder and any bladder obstructions and a cystoscopy, in which our doctors use a thin flexible fiber optic scope to check for abnormalities inside the urethra and the bladder.

Stress incontinence diagnosis can also include tests to see how you urinate. A uroflow test measures how your urine flows and how strong your urine stream is. Our doctors may perform a urine stress test to determine how your bladder can hold urine. Doctors will insert fluid into your bladder and see how your body responds to holding the urine until it's time to urinate. They will also ask you to cough and check for any leakage. By using the results of these tests, our doctors at Urology Specialists can provide a more accurate diagnosis and thus suggest the best type of treatment options available for your condition.