Male Incontinence Tests

Diagnosing stress urinary incontinence

Diagnosing stress urinary incontinence involves several steps. In order to determine the best option for treatment, it is important to know the severity of the incontinence. Methods to determine the severity include:

Pad Weights: In order to give an exact measure of the degree of leakage, we may ask patients to save all pads used for 24 hours in a zip-lock bag. These pads are then measured and compared to the weight of a dry pad. The weight difference shows the exact volume of leakage. This is an important step in determining the best treatment choice.

Cystoscopy: Cystoscopy involves placing a camera into the urethra in order to ensure there are no urethral strictures. If there are strictures, they must be treated before an incontinence procedure can be performed.

Bladder capacity measurement: At the time of the cystoscopy, patients fill their bladder as full as possible, then urinate into a container to measure how much urine the bladder can hold. Any residual urine in the bladder is also measured. This is key, as a patient with a larger bladder has better outcomes with a sling versus a urinary sphincter.

Diagnosing urge urinary incontinence

Diagnosing urge urinary incontinence is slightly different than stress urinary incontinence and focuses on finding the source of the bladder’s overactivity.

Urodynamics: This is essentially a stress test for the bladder. For this procedure, a catheter is placed in the urethra, another in the rectum and electrodes are attached to the pelvis. The bladder is then filled with warm saline and tested to see how well the bladder fills. Then, with the catheters in place, patients urinate and the strength of the stream and bladder are measured. The test can show us if the bladder is able to store urine normally, if it is working too hard to empty or if it is just oversensitive.

Cystoscopy: This test involves placing a camera into the urethra in order to ensure there are no urethral strictures. If there are strictures, we will need to treat them before an incontinence procedure can be performed. This is particularly important if you have had a previous procedure done for your prostate.

Flow and postvoid residual (PVR) measurement:  These are noninvasive tests that may be performed instead of an urodynamic evaluation. Patients come in with a full bladder and then urinate into a funnel to empty the bladder and measure the strength of the urine stream. Doctors then measure the remaining urine in the bladder. This test is helpful in determining how well you urinate and lets us know if we can start medications safely.