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 may also 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

Special tests

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, and may not be necessary to make a diagnosis or begin treatment. Tests include:

  • Measuring urine left in the bladder. This test is important if your bladder doesn'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 have 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 pressures. 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, if 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.

Your doctor will review the results of any tests with you and suggest a treatment strategy.

March 12, 2017
  1. Wein AJ, et al., eds. Overactive bladder. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov. 7, 2016.
  2. What is overactive bladder? Urology Care Foundation. http://www.urologyhealth.org/urologic-conditions/overactive-bladder-(oab)?article=112. Accessed Nov. 14, 2016.
  3. Gormley EA, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU Guideline Amendment. Journal of Urology. 2015;193:1572.
  4. Gormley EA, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guidelines. Journal of Urology. 2012;188:2455.
  5. Overactive bladder FAQ. National Association for Continence. http://www.nafc.org/oabfaq. Accessed Nov. 14, 2016.
  6. Overactive bladder. National Association for Continence. http://www.nafc.org/oabfaq. Accessed Nov. 14, 2016.
  7. South-Paul JE, et al. Urinary incontinence. In: Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com. Accessed Nov. 7, 2016.
  8. Nerve disease and bladder control. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/nerve-disease-and-bladder-control/pages/facts.aspx. Accessed Nov. 7, 2016.
  9. Willis-Gray MG, et al. Evaluation and management of overactive bladder: Strategies for optimizing care. Research and Reports in Urology. 2016;8:113.
  10. Lukacz ES. Evaluation of women with urinary incontinence. http://www.uptodate.com/home. Accessed Nov. 7, 2016.
  11. Kinsey D, et al. The psychological impact of overactive bladder: A systematic review. Journal of Health Psychology. 2016;21:69.
  12. Lightner DJ, et al. The overactive bladder and the AUA guidelines: A proposed clinical pathway for evaluation and effective management in a contemporary urology practice. Urology Practice. 2016;3:399.
  13. Urodynamic testing. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-topics/diagnostic-tests/urodynamic-testing/pages/urodynamic%20testing.aspx. Accessed Nov. 7, 2016.
  14. You are what you eat and drink. National Association for Continence. http://www.nafc.org/management/. Accessed Nov. 7, 2016.
  15. Lukacz ES. Treatment and prevention of urinary incontinence in women. http://www.uptodate.com/home. Accessed Nov. 7, 2014.
  16. Mo Q, et al. Acupuncture for adults with overactive bladder: A systematic review protocol. BMJ Open. 2015;5:1.
  17. Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Oct. 28, 2016.