Urinary Incontinence-Tests You May Need To Do

The purpose of the evaluation is to identify the cause of the incontinence, to determine the damage to the bladder and kidneys, and to select the appropriate treatment for the specific cause of the leakage. All of the tests can be performed in the office or as an outpatient at the hospital. All of the tests are associated with minimal discomfort. You can resume normal activity immediately following the procedures. The evaluation of urinary incontinence can include any of the following tests or procedures:

Cystoscopy – A local anesthetic is inserted into the urethra (the tube that drains the urine from the bladder). A small telescope is inserted in the urethra to examine the inside of the bladder. In women, a pelvic examination is performed at the end of the procedure. The examination takes approximately 5 minutes. After the procedure there may be a small amount of bleeding or mild burning with urination.

Flow Rate – This is a procedure to measure the efficiency of the bladder and the muscles or sphincters that hold the urine in the body. You will be asked to drink several glasses of water, When you feel that you have to urinate, you will be asked to urinate over a toilet that contains a recording device. The device will measure the volume of urine and the time it takes to empty your bladder.

Cystometrogram (CMG) – This is a procedure in which a small catheter (a plaster or rubber tube smaller than a pencil) is inserted into the bladder. The catheter is used to deliver sterile water or gas (carbon dioxide) into the bladder. You will be asked to describe the first sensation to urine and the strong urge to urinate. This procedure takes approximately 10-15 minutes. After the cystometrogram the catheter is removed and you will be asked to cough, strain and then urinate. This test is performed to determine the extent of leakage. You can expect some burning or passage of air with urination,

Voiding Diary – This is a record of the amount and time of day that urination takes place and when leakage occurs, (The amount of urination should be recorded in ounces.)

Voiding Cystourethrogram (VCUG) – This is an X-ray procedure in which a catheter is inserted in the bladder and the bladder filled with iodine. The catheter is removed and X-rays are taken while voiding.

Intravenous Pyelogram – This is an X-ray procedure that requires an injection of iodine into a vein and pictures are taken of the kidney at various time intervals. This determines the anatomy and the presence of damage to the kidneys. There is occasional nausea, bad taste in the mouth, or lightheartedness with the procedure. You will be asked to take laxatives before the procedure. (Please notify me or the radiologist if you are allergic to iodine or seafood.)

Not all of these diagnostic tests are required for each patient.

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