Diagnose Incontinence

Incontinence Evaluation and Diagnosis

If you think that you or someone you love is experiencing problems with either urinary or fecal incontinence, consult your doctor. Your doctor may do several tests to diagnose incontinence. For urinary incontinence the following information may be gathered:^[12]

• Bladder diary. Your doctor may ask you to keep a record of how much you drink, when you urinate, how much you urinate, urges, and number of times you couldn't control urination.

• Urinalysis. A sample of your urine will be tested for signs of infection, blood and other abnormalities.

• Blood test. Blood may be drawn and analyzed for chemicals and substances related to incontinence.

Advanced tests may be required and these may include:^[12]

• Postvoid residual (PVR) measurement. After urinating, your doctor will check to see how much urine remains in your bladder with a catheter or ultrasound. If urine is still there, you may have something blocking the urethra (tube emptying the bladder) or a problem with the muscles or nerves controlling the bladder.

• Pelvic ultrasound. An ultrasound can be used to find physical problems with the urinary tract or genitals.

• Stress test. If you take this test, you will be asked to cough or bear down with your abdomen to see if there is loss of urine.

• Urodynamic tests. This testing checks the pressure in your bladder when at rest and when being filled with water. A catheter will be used to put water into your bladder. The test tells the doctor about the strength of your bladder and muscles.

• Cystogram. X-rays are used to visualize the bladder during urination. A dye is injected into the bladder through a catheter. The dye allows makes the bladder visible when x-rays are used.

If fecal incontinence is an issue, your doctor may gather the following information:^[15]

• Medical history. Your doctor will ask for information about what you are experiencing including when and how often you are unable to control your bowels.

• Physical exam. Your doctor may perform a physical exam focusing on the area around your anus and genitals.

• Rectal exam. Your doctor will evaluate the strength of your muscles by inserting a lubricated finger in your rectum. You will be asked to bear down so the doctor can evaluate the strength of your muscles.

• Anal manometry. A balloon is inserted inside the rectum and inflated. It tests muscle strength and sensitivity.

• Anorectal ultrasound. An ultrasound is performed to look at the structures of the rectum and anus.

• Proctograph. Barium is used to coat the rectum. Then the doctor can use x-rays to determine how much stool the rectum can hold.

• Anal electromyograph. This is a test of the nerves controlling the anus.