A medical history is the most important part of the examination for
urinary incontinence. During the medical history, your
doctor will ask you to describe:
How long you have had
What, if anything, you are doing (laughing, sneezing,
coughing) when you experience incontinence.
How often you have the
problem and how much urine you lose.
Risk factors you may have that
could lead to incontinence.
Your eating habits.
bowel habits, to determine whether chronic constipation may be contributing to
Prescription and nonprescription medicines you
Treatments for previous problems affecting your urinary or
Your use of pads or other protective devices to
control urine leakage.
It may be easier for you to answer these questions if you use a bladder diary(What is a PDF document?) for 3 to 4 days before your appointment.
The doctor will ask questions about your general
health. To find out the cause of your incontinence, he or she will ask
specific questions about your urinary and reproductive tracts, your intestines,
and your nervous system.
Symptoms and conditions that are often related to incontinence will
also be investigated, such as:
Looking for growths, such as tumors, in the
Checking the pelvic muscle tone.
that the bladder has not dropped out of its proper position and that it is not
pressing on the vaginal wall.
Checking the nervous system to see if
a problem is causing muscle weakness or loss of reflexes.
Why It Is Done
A medical history and physical exam are done for everyone
who sees a doctor about urinary incontinence.
No growths or physical abnormalities are
The pelvic organs (uterus and bladder) have not dropped from
their normal position.
Pelvic muscle tone is firm.
abnormal muscle weakness, or reflex loss is due to a nerve
Constipation or a hard stool is not present.
Pain or discomfort occurs when the doctor
presses on the back or abdomen. (This may suggest a
urinary tract infection. Urinalysis and urine culture
may be needed.)
Growths or abnormalities that may be blocking the
urinary tract are detected during the pelvic or rectal examination. Ultrasound
or computerized tomography (CT scan) may be recommended.
muscle tone is weak, which may be a factor in stress incontinence. A bladder
stress test or pad test may be needed.
areas of the body, in addition to the urinary tract, show a loss of muscle
control or signs of Parkinson's disease or stroke. Referral to a neurologist
may be needed.
What To Think About
The medical history is important and can determine some causes of
Be sure to tell the doctor about all prescription
and nonprescription medicines you are taking.
The physical exam can find structural abnormalities of the
urinary tract that may be causing or contributing to incontinence. Findings
from the physical exam help your doctor know whether further testing is
ByHealthwise Staff Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAvery L. Seifert, MD - Urology