How Do Doctors Test for Urinary Incontinence in Women?

Medically Reviewed by Minesh Khatri, MD on May 28, 2023
3 min read

Accidental urine leakage -- doctors call it “urinary incontinence” -- is a sign of a bladder control problem. It can be annoying or very embarrassing. It can keep you from fully enjoying your life, too.

Your doctor can choose from a variety of tests to help pinpoint the cause. They can help you with a plan so you’ll have leaks less often.

Your doctor might ask you to do the old jump-into-the-pool move: pinch your nose and close your mouth. Breathe out hard, and they’ll likely know right away if you have a hard time holding in urine.

  • Pelvic Exam. This is another type of stress test. You’ll do it with a full bladder. While you’re sitting up, your doctor will ask you to cough. When you’re lying down, they’ll gently check out your pelvic organs. They’ll test your muscle strength in that area, too.
  • Rectal Exam. Your doctor will probably do this exam at the same time they do your pelvic exam. They’ll use a gloved, lubricated finger to feel inside your rectum. They’ll look for blockage that might be causing your problem.

Your doctor will likely ask you a simple series of questions. They might include:

  • How many times do you need to pee each day? Do you have to get up to go at night?
  • Do you “leak” urine while lifting, sneezing, laughing, coughing, or having sex?
  • Do you feel like your bladder is never completely empty?
  • Do you have a hard time making it to the bathroom in time?

If you answered “yes” to any of these questions, you might need to keep a daily bladder diary to give your doctor a clear idea about your condition. Details you’ll note include:

  • What and how much you drink
  • How often you go to the bathroom, and how much urine you release
  • What you’re doing when you get the urge to go
  • If there’s any warning before you leak

You’ll need to provide a urine sample. A lab test will reveal if there are blood traces or signs of infection.

Another test measures how much urine you release when you go, versus how much remains in your bladder. Your doctor will use a catheter (a thin, sterile tube) or do an ultrasound to see if you’re still holding pee. If you are, it could mean something is blocking your urinary tract. It could also mean there’s a nerve or muscle problem in your bladder.

Your doctor might want to draw some blood to send to the lab, too. It can show how well your kidneys are working, or whether your body chemistry is off.

Your doctor might need more information to diagnose your condition. If so, they’ll perform what’s known as a special test. This might include one of the following:

  • Cystogram. This is an X-ray of your bladder in action. Your doctor will use a catheter to inject dye into your urethra (the short tube that carries urine out of your body) and bladder. When you pee, they can see what happens, as well as if there are any problems.
  • Cystoscopy. Your doctor will insert a slender tube with a tiny lens into your urethra to check it out, as well as the lining of your bladder.
  • Pelvic ultrasound or renal ultrasound. This provides a picture that shows anything unusual about your urinary tract or genitals.
  • Urodynamic testing. Your bladder is filled with water, via a catheter. At the same time, a monitor measures the pressure that builds against your bladder walls. It also tests the strength of the muscle that controls the urine flow from your bladder. This helps to gauge what type of urinary incontinence you have.