Incontinence Special Tests

If incontinence still presents after treatment, additional testing may be needed. Urologists will perform urodynamic, endoscopic, and imaging tests.

If previous treatment fails, then need specialized tests to get a more extensive assessment of the lower urinary tract.

This test requires catheterization or pelvic ultrasound. The patient is requested to voids just before the PRV measurement. This initial void should be examine for hesitation, strain, or interrupted flow. A PRV of less than 50 mL indicates adequate bladder emptying (normal). If repeated measurements of 100 to 200 mL or higher indicates inadequate bladder emptying. Repeated measurements may be necessary to confirm the result.

Cystometry may be used to assess the anatomic and functional status of the bladder and urethra. The cystometer measures the pressure and capacity of the bladder; thus can assess the function of the detrusor muscle.

Uroflowmetry helps to diagnose any abnormal voiding patterns. Urethral pressure profilometry measures the resting and dynamic pressures in the urethra.

Cystoscopy helps to examine the presence of bladder lesions (e.g., cysts) and any foreign bodies.

X-rays and ultrasound may be used to assess physical conditions associated with urinary incontinence. Images of the lower urinary tract before, during, and after voiding may help to examine the anatomy of the urinary bladder and urethra.