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Urinary incontinence - loss of bladder control - When to seek medical advice.
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Urinary incontinence - loss of bladder control

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When to seek medical advice

You may feel uncomfortable discussing incontinence with your doctor. But seeking medical advice for incontinence is important for several reasons.

First, incontinence may indicate a more serious underlying condition, such as cancer or a nerve disorder. Second, incontinence may be causing you to restrict your activities and limit your social interactions to avoid embarrassment. In addition, urinary incontinence may increase the risk of falls in older adults as they rush to make it to the bathroom.

A few isolated incidents of incontinence don't necessarily require medical attention. But if incontinence is frequent or affecting your quality of life, talk to your doctor.

Screening and diagnosis

The first step in diagnosing urinary incontinence is to see your doctor for a complete medical exam.

Your doctor will ask about your symptoms and medical history. How often do you need to urinate? When do you leak urine? Do you have trouble emptying your bladder? Are you experiencing any symptoms in addition to incontinence? Your answers to these questions will help your doctor determine what type of incontinence you have.

A complete physical examination, focusing on your abdomen and genitals also may give clues to your incontinence. Your doctor will look for reasons for your incontinence, such as a urinary tract infection, mass, hernia or compacted stool.

If the reason for your incontinence is harder to find, your doctor may want to do some tests. These include:

  • Bladder diary. Your doctor may go over a bladder diary that he or she has asked you to complete at home over several days. You simply 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. To measure your urine, your doctor may give you a pan that fits over your toilet rim. The pan has markings like a measuring cup.

  • Urinalysis. A sample of your urine is sent to a laboratory, where it’s checked for signs of infection, traces of blood or other abnormalities. For the sample to be collected, you're asked to urinate into a container. A urine culture is a lab test that specifically checks for signs of infection in your urine. A urine cytology involves a check of your urine for cancer cells.

  • Blood test. Your doctor may have a sample of your blood drawn and sent to a laboratory for analysis. Your blood is checked for various chemicals and substances related to causes of incontinence.

If further testing is needed, you'll likely be referred to a doctor who specializes in urinary disorders in men and women (urologist). Women might also be referred to a doctor who focuses on urologic problems in women (urogynecologist). At the specialist's office, you may undergo additional testing such as:

  • Postvoid residual (PVR) measurement. This test helps your doctor determine whether you have difficulty emptying your bladder. For the procedure, you're asked to urinate (void) into a funnel-like container that allows your doctor to measure your urine output. Then your doctor checks the amount of residual urine in your bladder using a catheter — a thin, soft tube that's inserted into your urethra and bladder to drain any remaining urine — or an ultrasound device. For the ultrasound test, a wand-like device is placed over your abdomen. The device sends sound waves through your pelvic area. A computer transforms these sound waves into an image of your bladder, so your doctor can see how full or empty it is. A large amount of leftover (residual) urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.

  • Pelvic ultrasound. Ultrasound also may be used to view other parts of your urinary tract or genitals to check for abnormalities.

  • Stress test. For this test, you're asked to cough vigorously or bear down as your doctor examines you and watches for loss of urine.

  • Urodynamic testing. These are tests that measure pressure in your bladder both at rest and when filling. A doctor or nurse inserts a catheter into your urethra and bladder. The catheter is used to fill your bladder with water. As your bladder fills, pressure within your bladder is recorded. Normally, pressure increases by only very small amounts during filling. However, in some people with incontinence, the bladder goes into spasms as it fills. This test also helps your doctor measure the strength of your bladder muscle.

  • Cystogram. In this special X-ray of your bladder, a catheter is inserted into your urethra and bladder. Through the catheter, your doctor injects a fluid containing a special dye. As you urinate this fluid back out of your body, images show up on a series of X-rays. These images help reveal problems with your urinary tract.

  • Cystoscopy. In this procedure, a thin tube with a tiny lens (cystoscope) that allows your doctor to see the inside of your urethra and bladder is inserted into your urethra. With the aid of this device, your doctor can check for — and potentially remove — abnormalities in your urinary tract, such as bladder stones.

Complications

Urinary incontinence can cause rashes, skin infections and sores from constantly wet skin. Incontinence can also contribute to repeat urinary tract infections. But more distressing than these physical problems may be the effect incontinence can have on your quality of life.

Urinary incontinence may keep you from participating in activities. You may stop exercising, quit attending social gatherings or even refrain from laughing because you're afraid of an accident. You may even reach a point where you stop traveling or venturing out of familiar areas where you know the locations of toilets.

Urinary incontinence may negatively affect your work life. Your urge to urinate may keep you away from your desk or cause you to have to get up often during meetings. The problem may be so distressing that it disrupts your concentration at work. Urinary incontinence may also keep you up at night, so you're tired most of the time.

Perhaps most distressing is the impact incontinence can have on your personal life. Your family may not understand changes in your behavior or may grow frustrated at your many trips to the bathroom. You may avoid sexual intimacy because of embarrassment caused by urine leakage. It's not uncommon to experience anxiety and depression along with incontinence.

 

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Disclaimer

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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