When you’re leaking urine, your doctor needs to find out what’s causing it in order to treat you. There are a lot of different ways to test what’s behind your incontinence. You’ll need a physical exam and possibly one or more tests.
You can see your regular healthcare provider for this, or you may want to go straight to a urologist. They specialize in urinary tract problems.
Your doctor will first need to find out about your medical history before doing any tests. They’ll want to know about:
- Any medical conditions you have or have had in the past
- Medications you’re taking
- Your eating and exercising habits
- Symptoms you’re having
To help get a good sense of all the symptoms you might have, your doctor may also ask you about specific problems, like:
- Difficulty starting your urine stream
- Difficulty emptying your bladder all the way
- Spraying or dribbling urine when you go
- A weak stream of urine
- Urinary tract infections
- Pain when you urinate
Your doctor may also want to get a picture of your symptoms over a certain period of time. To get this information, they’ll ask you to keep a bladder diary (voiding log). They may even ask you to do this before you come in for the first time.
A bladder diary can help your doctor see if there are certain patterns to your urinary incontinence, so they can better figure out the causes and treatments that will work for you. In your diary, you’ll record:
- Each time you urinate (on purpose or not)
- How much urine comes out
- What caused your urination, if it was accidental (laughing, sneezing, etc.)
- Everything you eat and drink, and how much
One way your doctor can check to see if there’s a physical problem causing your urinary incontinence is by doing a rectal exam. To do this, they’ll ask you to either bend over an exam table or lie on your side with your knees pulled up to your chest. Then they’ll insert a gloved and lubricated finger into your rectum.
This test helps your doctor check your:
- Prostate -- If it’s larger than it should be, it could be the source of your problem.
- Rectum -- Your doctor can feel for masses or hardened or impacted stool. That can keep your urine from coming out the way it should.
They may also collect a sample of fluid from your prostate for testing. This will show them if you have signs of infection.
Urinary Incontinence Tests
After your medical history and physical exam, your doctor may do other tests:
Urine test -- Your doctor will ask you to urinate into a cup so they can look for blood, sugar, protein, or signs of infection in your urine.
Blood test -- This can tell your doctor if you’re having problems with your kidneys, a chemical imbalance, or problems with your prostate.
Ultrasound -- This shows your doctor an image of your bladder, to check for anything out of the ordinary.
Urodynamic tests -- This group of tests looks at how well your bladder fills and empties.
- Uroflowmetry: During this test, you’ll urinate into a special toilet or funnel. This collects your urine and also measures how quickly your urine comes out.
- Postvoid residual test: This test checks to see how much pee is left over after you urinate. Your doctor will either use an ultrasound to do this, or they’ll put a catheter into your urethra to drain urine from your bladder and measure the amount after you’ve tried to empty it yourself.
- Cystometric test: Your doctor uses a special catheter to fill your bladder with warm, sterile water. This catheter can measure the amount of pressure your bladder feels. Your doctor will ask how your bladder feels as the water fills it, and they may also have you cough. When you feel the urge to urinate, your doctor will take note of how much water is in your bladder, and how much pressure there is on it.
- Electromyogram: If your doctor suspects you have a problem with the nerves that tell the muscles in your urinary tract what to do, they may give you this test. It uses needle electrodes to record activity in your muscles as you squeeze them and let go.
- Cystoscopy: This procedure allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder.