Diagnosis of Overflow Incontinence continued...
Next, your doctor will perform a physical examination and look for signs of damage to the nerves that affect the bladder and rectum. Depending on the findings of the examination, your doctor may refer you to a urologist (a doctor who specializes in diseases of the urinary tract) or neurologist (a doctor who specializes in diagnosing and treating diseases of the nervous system).
Tests are often needed. These may include:
Bladder stress test. Your doctor checks to see if you lose urine when coughing.
Q-tip test. The doctor inserts a cotton swab into the urethra and has you cough and strain. Excessive movement of the swab could mean weakening of the tissues that support the bladder.
Catheterization. After having you go to the bathroom and empty your bladder, the doctor inserts a catheter to see if more urine comes out. A bladder that doesn't empty completely could indicate overflow incontinence.
Urinalysis and urine culture. Lab technicians check your urine for infection, other abnormalities, or evidence of kidney stones.
. An imaging test is performed to visualize inner organs such as the bladder, kidneys, and ureters.
If the diagnosis is still not clear, your doctor may order urodynamic testing. Urodynamic testing can evaluate bladder contractions, bladder pressure, urine flow, nerve signals, and leakage.
Other tests to confirm a diagnosis may include: cystocopy, a test that examines the inside of the bladder with a small scope called a cytoscope; and IVP, a procedure in which a special solution is injected into a vein in your arm and an X-ray is taken of your kidneys, ureters (the tubes that carry urine from the kidneys to the bladder), and bladder.
Treatments for Overflow Incontinence
Treating overflow incontinence can be difficult, but for some men with an enlarged prostate, treatment with a type of medication called an alpha-adrenergic blocker -- including doxazosin (Cardura), alfuzosin (Uroxatal), Minipress, tamulosin (Flomax), silodosin (Rapaflo), fesoterodine (Toviaz) and terazosin (Hytrin) -- can help relax the muscle at the base of the urethra and allow urine to pass from the bladder.
If medications do not relieve overflow incontinence, your doctor will have you use a catheter to ensure your bladder is emptied when you go to the bathroom. A catheter is a very thin tube that you can place in the urethra yourself. Your doctor or nurse can teach you how to self-catheterize. The process is simple, and single-use catheters are small enough to carry in your purse or pocket and are easy to dispose of after use.
Surgery may be needed if overflow incontinence is caused by a blockage, such as prostate enlargement.