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Diagnosis & Tests

To determine the cause of urinary incontinence, a number of tests can be performed. First your doctor will get your medical history, give you a physical and a pelvic exam. They will likely check for stress incontinence by asking you to cough. A urinalysis and urine culture may be used to find out if you have a urinary tract infection.

Your doctor may ask you how much you drink, what you drink and how  much and often you urinate. This information can be helpful in diagnosing the source of the problem.

A bladder stress test is done by inserting fluid into your bladder and asking you to cough. The Bonney test is exactly the same, except a finger or instrument is inserted into your vagina while you are asked to cough. If incontinence cannot be observed during an exam, a pad test can be used, which shows how much and how often you urinate in a given day.

Urodynamic testing if treatments have failed and if surgery is being weighed as an option. The test can include several components:

-Cystometry, which measures bladder pressure at different amounts of fullness. This test includes leak point pressure which measures the strength of the muscle that controls urine. It also includes maximal urethral closure pressure, which measures the pressure keeping the urethra naturally closed. And lastly, it includes postvoid residual measurement, x-rays and ultrasounds. These can track the movement of the urethra and bladder during urination or stress events.

If all of these tests fail to determine the cause, there are two more options. A cystoscopy looks at the urethra and bladder from inside, using a scope to determine if there are abnormalities. There is also a type of X-ray called voiding cystourethrogram that determines the shape of the lower urinary tract. This can expose abnormalities in the urinary tract.

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