Diagnostic Tests of Urinary Incontinence

In assessing women with urinary incontinence is the history and physical examination are complete. Preliminary examination is not always diagnostic, but the information obtained will guide the clinician preformance choose the necessary diagnostic tests. In general, patient complaints, namely :

• Urine out when coughing, laughing, sneezing and exercise.
• Urinary discharge can not be detained.
• Urine dripping on the state of the bladder is full.

Complete physical examination includes examination of the abdomen, vaggginal, pelvic, rectal and neurological assessment. On abdominal examination can be obtained distended bladder, which shows an overflow incontinence, and confirmed by catheterization. Inspeculo can seem genital prolapse, cystocele and rectocele. The presence of urine in vagggina especially after a hysterectomy may be aware of a pelvic mass.

Simple test can be done after a physical examination to help determine the next action. Q-tip test ('the cotton swab test'), is a simple test to indicate the presence of genuine stress incontinence. Patients were told to empty the bladder, urine accommodated. Then the urine specimen taken by catheterization . The amount of urine from the urinary and bladder catheter is volume. Residual volume confirmed the diagnosis of overflow incontinence. Urine specimens sent to the laboratory.

Further diagnostic tests are cystourethroscopy and diagnostic imaging. Cystourethroscopy done with general anesthesia and without anesthesia, can be seen in pathological states such as fistula, ectopic ureter or diverticulum. Test urodynamic include uroflowmetry and cystometry. Cystometry is a test that is most important, because it can show the state of hyperactive bladder, both normal and hypoactive. Diagnostic imaging includes ultrasound, CT scans and IVP are used to identify pathological abnormalities (such as fistula / tumor) and anatomical abnormalities (ectopic ureter).

Additional tests are required for diagnostic evaluation that is 'pad pessary test'. People drink 500 ml of water for 15 minutes to fill the bladder. After half an hour, the patient exercises for 45 minutes by means of : standing from sitting (10 times), cough (10 times) , jogging in place (11 times), pick up objects from the floor (5 times), and hand washing of water for 1 minute. Test Pad positive when the weight equal to or greater than 1g. this test can indicate the presence of stress incontinence only if not obtained an unstable bladder.