If you have an abnormal urge to urinate, your doctor will check to make sure that you don't have an infection or blood in your urine. Your doctor also may want to make sure that you're emptying your bladder completely when you urinate.
Your doctor will look for clues that might also indicate contributing factors. The work-up will likely include a:
- Medical history
- Physical exam, focusing on your abdomen and genitals
- Urine sample to test for infection, traces of blood or other abnormalities
- Focused neurological exam that may identify sensory problems or abnormal reflexes
Your doctor may order a simple urodynamic test to assess the function of your bladder and its ability to empty steadily and completely. These tests usually require a referral to a specialist. Tests include:
- Measuring urine left in the bladder. This test is important if your bladder can't empty completely when you urinate or experience urinary incontinence. Remaining urine (postvoid residual urine) may cause symptoms identical to an overactive bladder. To measure residual urine after you've voided, your doctor may request an ultrasound scan of your bladder or pass a thin tube (catheter) through the urethra and into your bladder to drain and measure the remaining urine.
- Measuring urine flow rate. To measure the volume and speed of your voiding, you may be asked to urinate into a uroflowmeter. This device translates the data into a graph of changes in your flow rate.
- Testing bladder pressure. Cystometry measures pressure in your bladder and in the surrounding region during bladder filling. During this test, your doctor uses a thin tube (catheter) to fill your bladder slowly with warm water. Another catheter with a pressure-measuring sensor is placed in your rectum or, of you're a woman, in your vagina. This procedure can identify whether you have involuntary muscle contractions or a stiff bladder that's not able to store urine under low pressure. You may be asked to void during the study (pressure-flow study), which can also measure the pressure used to empty your bladder and indicate whether or not you have a bladder blockage (obstruction).
Your doctor will review the results of any tests with you and suggest a treatment strategy
Jan. 16, 2013
- Marinkovic SP, et al. The management of overactive bladder syndrome. BMJ. 2012;344:e2365.
- South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=52. Accessed Dec. 19, 2012.
- Overactive bladder. American Urological Association. http://www.urologyhealth.org/urology/index.cfm?article=112. Accessed Dec. 19, 2012.
- What I need to know about bladder control for women. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/bcw_ez/. Accessed Dec. 19, 2012.
- Ellsworth PI, et al. Frequently asked questions in the evaluation and management of overactive bladder. Journal of Family Practice. 2009;58(suppl):s1.
- Treatment of overactive bladder in women. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/bladder/bladder.pdf. Accessed Dec. 19, 2012.
- DuBeau CE. Clinical presentation and diagnosis of urinary incontinence. http://www.uptodate.com/index. Accessed Dec. 19, 2012.
- Urodynamic testing. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/urodynamic/. Accessed Dec. 19, 2012.
- DuBeau CE. Treatment of urinary incontinence. http://www.uptodate.com/index. Accessed Dec. 19, 2012.
- Anger JT, et al. Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: A systematic review of the literature. The Journal of Urology. 2010;183:2258.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 21, 2012.
- Subak LL, et al. Weight loss to treat urinary incontinence in overweight and obese women. New England Journal of Medicine. 2009;360:481.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.