Medically Reviewed by Gary H. Emerson, MD

As women age or have babies, many suffer urinary leakage or incontinence and feel that it’s a problem they “just have to live with.” But there is help for women with stress incontinence along with others who feel they have to go to the bathroom even when their bladder isn’t full (urge incontinence).

“The first step in treating the potentially embarrassing problem of female incontinence is a series of simple tests,” says McLeod Gynecologist Dr. Gary Emerson. “Most of these tests can be conducted right in your doctor’s office to help pinpoint the cause of your problem. Even before you see your doctor, you can start by keeping what we call a ‘bladder diary.’”

Bladder Diary

For 3-7 days, keep track of when you urinate, the length of time you urinate, and whether it was an accident or planned. Try to judge the amount of urine as best you can. Write down what and how much you drank during the day.

Take this with you when you see your doctor.  

Physical Exam

Your physician will start with a general checkup, looking for swelling or other abnormalities. The doctor will assess your abdomen for bowel sounds, bladder fullness or tenderness. 

The doctor may ask if you have trouble starting a urine flow or, once started, if you can maintain the flow.

As part of this general exam, a urine sample will be tested for bacteria as well as sugar and protein.

Stress Test

You may be asked to jump up and down or cough with a full bladder. The doctor can see if there is any leakage and if so, the amount of leakage.

Other tests may be needed to better pinpoint the problem and plan the treatment.

Urodynamic Testing

To measure pressure and urine flow, a patient’s bladder will be filled through a tube inserted by the doctor. Using an ultrasound device (similar to those used for pregnant women), the doctor can check for physical abnormalities, then watch the bladder as it fills and empties. The amount of urine remaining in the bladder (Postvoid Residual Volume) is measured.

At this point, the doctor generally has enough information to move onto a discussion of treatments for you. However, in some cases, a closer look may be required.

Cystoscopy

One of those procedures uses a small wand-like device with a light and camera to look inside the urinary system for growths or obstructions.

Moving on to Treatment

Once the cause or source of your problem is identified, there are a range of treatments to be considered from exercises to surgery.

As always, discuss your treatment options with your doctor, because each person’s case is unique.

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Sources include: McLeod Health, National Institutes of Health, National Association for Continence, American College of Obstetricians and Gynecologists, Incontinence Resource Center