If you experience urinary incontinence, see your GP. Do not be embarrassed to speak to your GP about your condition.
To provide treatment, your GP will need to determine which type of urinary incontinence you have and what may be causing it. They will ask you several questions about your symptoms and medical history, such as:
- 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 that you can give them as much information as possible about your condition. Include details such as:
- how much fluid you drink
- the type 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. This may include asking you to cough while you are undressed from the waist down 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 also 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, which is the tube that carries urine from the bladder to outside 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 may GP carry out a digital rectal examination (DRE) to check the health of your prostate gland. This involves inserting their finger into your anus. See the Health A-Z topic about DRE for more information about this procedure.
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. Overflow incontinence is when your bladder cannot completely empty when you try to pass urine.
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.
Urodynamic tests
Urodynamic tests are a group of tests 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 rectum (back passage)
- asking you to urinate into a special machine that measures the amount and flow of the urine
