How To Diagnose Urinary Incontinence

Inability to hold your urine due to sphincter or bladder related issues can lead to a wide variety of embarrassing situations. In addition, it also makes it difficult for you to continue your personal or professional relationships as there is a frequent need to rush to the bathroom. People who suffers from Urinary incontinence often confine themselves to their homes or isolated setting to avoid embarrassment caused by urinary accidents. A lot of people adopt unhealthy habits and practices to control the symptoms; such as greatly reducing the fluid intake which can lead to dehydration, metabolic derangements, electrolyte imbalance or even renal dysfunction in extreme cases. Yet such interventions doesn’t help in resolving the core issue and some people end up using diapers or pads to deal with this situation.

What To Do If You Are Experiencing Urinary Incontinence?

Individuals who are suffering from bladder incontinence can restore the normal quality of life by seeking medical help as early as possible. The first step to management is detection or diagnosis of core issue.

The classic symptoms of urinary incontinence are:

• Continuous leakage or dribbling of urine
• Frequent trips to the restroom (up to 8 times or more times in 24 hours)
• A strong urge to urinate
• Unable to reach the restroom in time
• Accidental wetting
• Uncontrolled loss of urine

What To Expect On The Clinical Assessment Of Urinary Incontinence?

If you are experiencing above symptoms then you must refer to a doctor (ideally urologist) for the clinical assessment. Unfortunately, most people feel ashamed about talking to someone regarding their urinary complaints which can delay the treatment process. Your medical history and current condition helps the doctor in diagnoses the issue and suggesting a suitable treatment. Besides verbal history, a complete abdominal and pelvic examination is also required. A questionnaire including information about voiding is mandatory in determining the severity of urinary incontinence.

If a neurological condition is suspected, then your doctor will suggest an MRI. Though rarely but evaluation of kidneys is also needed.

Urodynamic Studies

It is a thorough examination of urinary bladder and is done when the cause of urinary incontinence, is not clearly understood. It includes multiple tests, evaluating the pressure and function of bladder along with the flow of urine. This diagnostic test gives complete information about the strength of bladder, blockage (if any), capacity of bladder to hold the urine and over-activity of bladder.

Urodynamic studies also helps in determining what treatment options are most suitable; pharmacological agents or a surgery.

Details Of Urodynamic Study - The Procedure

• The test is ideally performed on an empty bladder to find how quickly you are urinating and how long can your bladder hold the urine.
• The technician then insert a flexible, lubricated small catheter inside bladder via urethra and another catheter is inserted inside the rectum. This procedure is performed using a local anesthetic jelly to minimize discomfort.
• Now both catheters are connected to the computer
• Three small pads are placed in order to check the functioning of valves below the bladder.
• In the end, your bladder is going to be filled with sterile water and you will be asked to sit on a commode. Functioning will be monitored via computer. To check if urine leaks, you will be asked to cough or toil. When you have feeling that your bladder is completely filled, you will be asked to urinate.

This whole procedure takes about 30 to 45 minutes and after the procedure catheters are removed and doctor prescribe antibiotics to minimize the risk of infection.

Some Points To Know

• Try to have empty bowel before test
• You don’t have to come with full bladder if catheter is already inserted
• Fasting is not required
• You can take your usual medications
• It is necessary to inform your doctor if you had replacement of knees, hip or heart valves or you are taking antibiotics for a dental procedure.

What To Expect After Urodynamic Studies?

For 24 hours you should drink a lot of water to completely wash off your bladder from any pathogen. There can be little bleeding or discomfort but it will settle on its own within 48 hours. Usually there is no infection but if you have fever or pain during urination, immediately seek doctor’s help.

References

1. Clement, K. D., Lapitan, M. C. M., Omar, M. I., & Glazener, C. (2013). Urodynamic studies for management of urinary incontinence in children and adults. The Cochrane Library.

2. Nitti, V. W., Rosenberg, S., Mitcheson, D. H., He, W., Fakhoury, A., & Martin, N. E. (2013). Urodynamics and safety of the β 3-adrenoceptor agonist mirabegron in males with lower urinary tract symptoms and bladder outlet obstruction. The Journal of urology, 190(4), 1320-1327.

3. Abrams, P., Chapple, C., Khoury, S., Roehrborn, C., & De la Rosette, J. (2013). Evaluation and treatment of lower urinary tract symptoms in older men. The Journal of urology, 189(1), S93-S101.