Urinary Incontinence

Diagnosis

Cystoscopy allows the doctor to examine the inside of the bladder.

Enlarge

Mayo Clinic specialists spend time with each patient to evaluate the type of incontinence and the underlying causes before developing a treatment plan.

The first step is a comprehensive medical history and physical examination by the doctor. To determine the type, severity and duration of urinary incontinence, the following tests frequently are ordered:

• Blood tests
• Urinalysis or urine culture to rule out urinary tract infection or other abnormalities
• Pad test (after placement of a pre-weighed sanitary pad, the patient is asked to exercise — following exercise, the pad is re-weighed to determine the amount of urine loss)
• Cystoscopy (inspection of the inside of the bladder)
• Urodynamic studies (tests to measure pressure and urine flow), including:
  • urinary post-void residual (PVR) to measure how much urine remains in the bladder after urination
  • urinary stress test (checks for urine loss when bladder muscles are stressed, usually by coughing, lifting or exercise)

Mayo Clinic specialists may recommend additional tests if:

• The diagnosis is still unclear
• An adequate trial of therapy fails
• Surgery is a treatment option
• Blood is present in the urine, without sign of infection
• Other conditions exist, such as urinary tract infection, persistent difficulty emptying or initiating emptying of the bladder, previous surgery or radical pelvic surgery, presence of pelvic relaxation or neurological problems.

Additional tests may include a pelvic or abdominal ultrasound, X-rays with contrast dye of the kidneys and bladder, or an EMG (electromyogram) to study muscle activity in the urethra or pelvic floor.