Preparing for your appointment
If you have urinary incontinence, you’re likely to start by seeing your family doctor or a general practitioner. You may be referred to a doctor who specializes in urinary tract disorders (urologist), or if you’re a woman, a gynecologist with special training in female bladder problems and urinary function (urogynecologist).
WHAT YOU CAN DO
To get ready for your appointment, it helps to:
- Be aware of any pre-appointment restrictions, such as restricting your diet.
- Write down your symptoms, including how often you urinate, nighttime bladder activity and episodes of incontinence.
- Make a list of all your medications, vitamins and supplements, including doses and how often you take the medication.
- Write down key medical information, including other conditions you may have.
- Ask a relative or friend to accompany you, to help you remember what the doctor says.
- Take a notebook or electronic device with you, and use it to note important information during your visit.
- Write down questions to ask your doctor.
For urinary incontinence, some basic questions to ask your doctor include:
- What’s the most likely cause of my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is my urinary incontinence temporary?
- What treatments are available?
- Should I anticipate any side effects of the treatment?
- Is there a generic alternative to the medicine you’re prescribing for me?
- I have other health conditions. How can I best manage these conditions together?
Don’t hesitate to ask other questions during your appointment as they occur to you.
WHAT TO EXPECT FROM YOUR DOCTOR
Your doctor is likely to ask you a number of questions, such as:
- When did you first begin experiencing symptoms, and how severe are they?
- Have your symptoms been continuous or occasional?
- What, if anything, seems to improve or worsen your symptoms?
- How often do you need to urinate?
- When do you leak urine?
- Do you have trouble emptying your bladder?
- Have you noticed blood in your urine?
- Do you smoke?
- How often do you drink alcohol and caffeinated beverages?
- How often do you eat spicy, sugary or acidic foods?
Tests and diagnosis
It’s important to determine the type of urinary incontinence that you have. That information will guide treatment decisions.
Your doctor is likely to start with a thorough history and physical exam. You may then be asked to do a simple maneuver that can demonstrate incontinence: close your mouth, pinch your nose shut and exhale hard.
After that, your doctor will likely recommend:
- Urinalysis. A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
- Bladder diary. For several days you record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
- Post-void residual measurement. You’re asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of leftover urine in your bladder using a catheter or ultrasound test. A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.
If further information is needed, your doctor may recommend:
- Urodynamic testing. A doctor or nurse inserts a catheter into your urethra and bladder to fill your bladder with water. Meanwhile, a pressure monitor measures and records the pressure within your bladder. This test helps measure your bladder strength and urinary sphincter health, and it’s an important tool for distinguishing the type of incontinence you have.
- Cystoscopy. Your doctor inserts a thin tube with a tiny lens into your urethra. Your doctor can check for, and possibly remove, abnormalities in your urinary tract.
- Cystogram. Your doctor inserts a catheter into your urethra and bladder and injects a special dye. As you urinate and expel this fluid, X-ray images of your bladder help reveal problems with your urinary tract.
- Pelvic ultrasound. Your urinary tract or genitals are checked for abnormalities.