To diagnose the type of urinary incontinence you have, your healthcare provider will ask you several questions about your symptoms, such as:

• When did your symptoms start, and how severe are they?
• Are your symptoms continuous or occasional?
• How often do you need to urinate during the day and over the night?
• When do you leak urine?
• Do you leak when you have a sudden urge you can’t control?
• Do you leak when you cough, laugh, or sneeze?
• Do you have other problems urinating, such as trouble starting your stream or emptying your bladder?
• Have you noticed blood in your urine?
• Do you have any pain or burning when you urinate?

Other Factors

Your healthcare provider will also ask questions about other factors that could be contributing to UI, such as:

• Do you smoke?
• How often do you drink alcohol and caffeinated beverages?
• How often do you eat spicy, sugary, or acidic foods?
• What medications do you take (including prescription and non-prescription, vitamins, and supplements)?
• What other medical conditions do you have?

Tests

Your provider will do a physical examination. This exam may include a pelvic examination for women and a prostate examination for men. Other things your provider may do to help make the diagnosis include:

• Urinalysis. This is when your urine is tested for infection, blood, or other abnormalities.
• Have you keep a bladder diary. You may be asked to track and write down information including what time you urinate, how much urine you pass, what symptoms you experience, and the number of times you have leaking over a period of two to three days. You may also be asked to write down other information, such as what you drink and eat.
• Stress test. Your provider will have you cough or “bear down” and watch for any loss of urine.
• Ultrasound. This is done in the clinic at the time of your visit.  It will measure how much urine is left in your bladder after urinating (called “post-void residual”).A large post-void residual may mean you are having difficulty emptying the bladder.

Usually, only the urinalysis is definitely needed.  Your provider may or may not need to do the other tests, depending on your situation. Your provider may refer you to see a specialist such as a urologist, urogynecologist (gynecologist who specializes in pelvic and bladder problems), or geriatrician.

Less commonly, your provider or a specialist may recommend special tests, such as:

• Urodynamic testing. A catheter is inserted into your urethra to fill your bladder with water, and the pressure in the bladder is recorded to help measure your bladder strength as your bladder is filled and when you urinate.
• Cystoscopy. Your doctor inserts a thin tube with a lens through the urethra into the bladder to look for any abnormalities in the urinary tract.
• Pelvic ultrasound. Your urinary tract or genitals are checked for abnormalities with an ultrasound.

Last Updated February 2023