The diagnosis is usually made after your doctor has taken a complete history and performed a thorough physical examination. Basic and further investigations will be planned depending on the initial assessment.
History taking involves asking you questions about your symptoms, details about your previous pregnancies, medical and surgical history and medications. Your doctor may also enquire about sexual history and how your condition may have affected your daily activities and quality of life. You may also be asked to complete a bladder diary for up to three days, including both working days and days off.
Abdominal and pelvic examination
will be performed to assess for any
possible tumours, co-existing pelvic
organ prolapse, strength of pelvic floor
muscle contraction or signs of vaginal
atrophy. An erect stress test – where
the patient will be asked to stand on an
incontinence sheet and cough about 10
times, to assess for any urinary leakage,
is usually performed. If necessary,
a neurological examination may also
Further tests will be ordered after the
doctor’s initial assessment.
Most commonly, a urine dipstick test to
look for blood, glucose, protein, white
blood cells and nitrites will be done.
Urine cultures to exclude urinary tract
infection may also be part of the initial
Post-void residual urine volume
should be measured in women who
have symptoms suggesting voiding
dysfunction or recurrent urinary tract
infections. This may be performed using
a bladder scan or catheterisation.
For some people, urodynamics studies,
a complex assessment of changes
in bladder activity during filling and
emptying, may be required to confirm
the diagnosis and decide on treatment
options, especially if surgery for urinary
incontinence is considered.
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