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Patients with incontinence should be referred to a medical practitioner specializing in this field. Urologists specialize in the urinary tract, and some urologists further specialize in the female urinary tract. A urogynecologist is a gynecologist who has special training in urological problems in women. Gynecologists and obstetricians specialize in the female reproductive tract and childbirth and some also treat urinary incontinece in women. Family practitioners and internists see patients for all kinds of complaints and can refer patients on to the relevant specialists.
A careful history taking is essential especially in the pattern of voiding and urine leakage as it suggests the type of incontinence faced. Other important points include straining and discomfort, use of drugs, recent surgery, and illness.
The physical examination will focus on looking for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.
A test often performed is the measurement of bladder capacity and residual urine for evidence of poorly functioning bladder muscles.
Other tests include:
* Stress test - the patient relaxes, then coughs vigorously as the doctor watches for loss of urine.
* Urinalysis - urine is tested for evidence of infection, urinary stones, or other contributing causes.
* Blood tests - blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
* Ultrasound - sound waves are used to "see" the kidneys, ureters, bladder, and urethra.
* Cystoscopy - a thin tube with a tiny camera is inserted in the urethra and used to see the inside of the urethra and bladder.
* Urodynamics - various techniques measure pressure in the bladder and the flow of urine.
Patients are often asked to keep a diary for a day or more, up to a week, to record the pattern of voiding, noting times and the amounts of urine produced.
Urinary incontinence in women
Women experience incontinence twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, congenital defects, strokes, multiple sclerosis, and physical problems associated with aging.
While urinary incontinence affects older women more often than younger women, the onset of incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages.
Incontinence in women usually occurs because of problems with muscles that help to hold or release urine. The body stores urine - water and wastes removed by the kidneys - in the urinary bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. It can result when the fetus pushes down and places pressure on the bladder. It can even continue after birth, until weakened pelvic muscles become stronger.
During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body. Incontinence will occur if the bladder muscles suddenly contract or muscles surrounding the urethra suddenly relax.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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