Urinary incontinence, the involuntary loss of urine, affects an estimated 25 million Americans, mostly women. For most, incontinence is the result of problems controlling the bladder. For people with a type called functional incontinence, however, the problem lies in getting to and using the toilet when the need arises.
The doctor will ask questions about your general
health. To find out the cause of your incontinence, he or she will ask
specific questions about your urinary and reproductive tracts, your intestines,
and your nervous system.
Symptoms and conditions that are often related to incontinence will
also be investigated, such as:
Looking for growths, such as tumors, in the
Checking the pelvic muscle tone.
that the bladder has not dropped out of its proper position and that it is not
pressing on the vaginal wall.
Checking the nervous system to see if
a problem is causing muscle weakness or loss of reflexes.
Why It Is Done
A medical history and physical exam are done for everyone
who sees a doctor about urinary incontinence.
No growths or physical abnormalities are
The pelvic organs (uterus and bladder) have not dropped from
their normal position.
Pelvic muscle tone is firm.
abnormal muscle weakness, or reflex loss is due to a nerve
Constipation or a hard stool is not present.
Pain or discomfort occurs when the doctor
presses on the back or abdomen. (This may suggest a
urinary tract infection. Urinalysis and urine culture
may be needed.)
Growths or abnormalities that may be blocking the
urinary tract are detected during the pelvic or rectal examination. Ultrasound
or computerized tomography (CT scan) may be recommended.
muscle tone is weak, which may be a factor in stress incontinence. A bladder
stress test or pad test may be needed. (For more information, see the Exams and
Tests section of the topic Urinary Incontinence in Women.)
areas of the body, in addition to the urinary tract, show a loss of muscle
control or signs of Parkinson's disease or stroke. Referral to a neurologist
may be needed. (For more information, see the topic Parkinson's Disease or
What To Think About
The medical history is important and can determine some causes of
Be certain to tell the doctor about all prescription
and nonprescription medicines you are taking.
The physical exam can find structural abnormalities of the
urinary tract that may be causing or contributing to incontinence. Findings
from the physical exam help determine whether further testing is