Because urinary incontinence is a symptom, as opposed to a disease, an accurate diagnosis is key to effective treatment. To diagnose the cause of your bladder problems, your health-care professional will ask you a number of questions, do a physical exam and, in some cases, order blood, urine and bladder tests.

Be prepared to give a detailed history of the problem, including information about:

• previous illnesses and surgeries
• any medications you may be taking
• how much and what you drink
• how often you urinate
• how often you have leakage
• when the leakage occurs

Your health-care professional will do a pelvic exam to test the strength of your pelvic floor muscles and determine if your bladder and uterus have slipped from their normal position. He or she may want to have your blood and urine analyzed to look for signs of infection or other conditions, such as diabetes, which can cause incontinence.

Urodynamics

Urodynamics are a series of tests that give a detailed picture of how your bladder is working. Your doctor may order these tests when conservative measures, such as exercise, biofeedback, diet and medication, do not help.

In some cases, you may be asked to empty your bladder immediately before testing begins, or you may be asked to empty your bladder into a special toilet or using a catheter, a thin tube inserted through the urethra into the bladder. For those individuals who require antibiotics before going to the dentist because of heart problems or previous orthopedic surgeries, remember to take the antibiotic at least one hour before the urodynamics appointment. Procedures that involve the use of catheters may cause short-term discomfort for some women.

Urodynamic tests include:

Flow Rate Measurement
To measure how fast and how much your bladder empties, you will be asked to urinate into a special toilet. No catheter is used.

Residual Urine Measurement
This test measures how much urine is left in your bladder after you have voided. You will be asked to empty your bladder before the test. A catheter is then inserted into your bladder and the remaining urine is drained and measured.

Bladder Filling Cystometry
This test measures how much your bladder can hold, the pressure within your bladder as it stores urine, and how full it is when you feel the need to urinate. You may be asked to cough or strain in an attempt to cause leaking. You will be asked to say when you first feel the need to urinate and when your bladder is full.

Voiding Study
To detect problems in urine flow, a catheter is inserted to measure the pressure generated when you void. You will be asked to empty your bladder into a flowmeter.