Urinary incontinence - Diagnosis 

Diagnosing urinary incontinence 

If you experience urinary incontinence, see your GP so they can determine the type of condition you have.

Do not be embarrassed to speak to your GP about your condition.

Your GP will ask you questions about your symptoms and medical history, including:

  • whether the urinary incontinence occurs when you cough or laugh
  • whether you need the toilet frequently during the day or night
  • whether you have any difficulty passing urine when you go to the toilet 
  • whether you are currently taking any medications
  • how much fluid, alcohol or caffeine you drink 

Bladder diary

Your GP may suggest that you keep a diary of your bladder habits for at least three days, so you can give them as much information as possible about your condition. This should include details such as:

  • how much fluid you drink
  • the types of fluid you drink
  • how often you need to pass urine
  • the amount of urine you pass
  • how many episodes of incontinence you experience 
  • how many times you experience an urgent need to go to the toilet

Tests and examinations 

You may also need to have some tests and examinations so that your GP can confirm or rule out external factors that may be causing your incontinence. Some of these are explained below.

Physical examination

Your GP may examine you physically to assess the health of your urinary system.

If you are female, your GP will carry out a pelvic examination, which usually involves undressing from the waist down. You may be asked to cough to see if any urine leaks out.

Your GP may also examine your vagina. In over half of women with stress incontinence, part of the neck of the bladder may bulge into the vagina.

Your GP may place their finger inside your vagina and ask you to squeeze it with your pelvic floor muscles. These are the muscles that surround your bladder and urethra (the tube through which urine passes out of the body). Damage to your pelvic floor muscles can lead to urinary incontinence.

If you are male, your GP may check whether your prostate gland is enlarged. The prostate gland is located between the penis and bladder, and surrounds the urethra. If it is enlarged, it can cause symptoms of urinary incontinence, such as a frequent need to urinate.

Your GP may carry out a digital rectal examination to check the health of your prostate gland. This will involve your GP inserting their finger into your bottom. 

Dipstick test

If your GP thinks that your incontinence may be caused by an infection, a sample of your urine may be tested for bacteria. A small, chemically treated stick will be dipped into your urine sample. It will change colour if bacteria are present. The dipstick test can also check the blood and protein levels in your urine.

Residual urine test

If your GP thinks you may have overflow incontinence, also called chronic urinary retention, they may suggest a residual urine test. 

A residual urine test involves inserting a thin, flexible hollow tube, called a catheter, into your urethra and feeding it through to your bladder. Any urine that is left in your bladder will drain out through the catheter and the amount can be measured.

Further tests

Some further tests may be necessary if the cause of your urinary incontinence is not clear. Your GP will usually start treating you first and could then suggest these tests if treatment is not effective. 

Bladder ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of the inside of your body. An ultrasound scan of your bladder can show how much urine is left in your bladder after you go to the toilet.

Cystoscopy

A cystoscopy involves using a flexible viewing tube, known as an endoscope, to look inside your bladder and urinary system.

This test can identify abnormalities that may be causing incontinence.

Urodynamic tests

Urodynamic tests are a group of tests used to check the function of your bladder and urethra. This may include keeping a bladder diary for a few days (see above) and then attending an appointment at a hospital or clinic for some tests. These could include:

  • measuring the pressure in your bladder by inserting a catheter into your urethra
  • measuring the pressure in your abdomen by inserting a catheter into your bottom
  • asking you to urinate into a special machine that measures the amount and flow of the urine

Page last reviewed: 21/09/2012

Next review due: 21/09/2014

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