Tests and diagnosis

By Mayo Clinic Staff

It's important to determine the type of urinary incontinence that you have. That information will guide treatment decisions.

Your doctor is likely to start with a thorough history and physical exam. You may then be asked to do a simple maneuver that can demonstrate incontinence: close your mouth, pinch your nose shut and exhale hard.

After that, your doctor will likely recommend:

  • Urinalysis. A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
  • Bladder diary. For several days you record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
  • Post-void residual measurement. You're asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of leftover urine in your bladder using a catheter or ultrasound test. A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.

Special testing

If further information is needed, your doctor may recommend:

  • Urodynamic testing. A doctor or nurse inserts a catheter into your urethra and bladder to fill your bladder with water. Meanwhile, a pressure monitor measures and records the pressure within your bladder. This test helps measure your bladder strength and urinary sphincter health, and it's an important tool for distinguishing the type of incontinence you have.
  • Cystoscopy. Your doctor inserts a thin tube with a tiny lens into your urethra. Your doctor can check for, and possibly remove, abnormalities in your urinary tract.
  • Cystogram. Your doctor inserts a catheter into your urethra and bladder and injects a special dye. As you urinate and expel this fluid, X-ray images of your bladder help reveal problems with your urinary tract.
  • Pelvic ultrasound. Your urinary tract or genitals are checked for abnormalities.
Aug. 07, 2014