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The Center for Women's Continence and Pelvic Health uses the most up-to-date testing procedures to arrive at an individualized diagnosis and treatment plan. Before ordering diagnostic testing, however, a physician might use the following non-invasive techniques to estimate the type or severity of incontinence:
- Having the patient bear down as if having a bowel movement to assess the degree of prolapse
- Keeping a daily diary of bladder activity
- Performing a standing cough stress test to assess leakage
- Wearing a sanitary pad placed against the vagina and perineum. With - and without - a change of color on the pad, it can be determined whether the discharge is urine or normal vaginal fluid.
- Perform a detailed examination to determine the cause of pain during sexual activity or to assess the amount of control a woman has over her pelvic floor musculature.
Some of the diagnostic procedures used at the center include:
- Complex uroflowmetry is a procedure that measures the amount of urine in the bladder and its flow rate. Decreased urine flow might be the result of inadequate bladder muscle contraction or prolapse (when the bladder drops from its usual position) which can kink the urethra. An increased rate of flow may indicate stress urinary incontinence or sphincter dysfunction.
- Cysto-urethroscopy, also known as cystoscopy, is a procedure used to examine in detail the inside of the bladder and urethra. After receiving a local anesthetic, a cystoscope (a tube with a small camera) is inserted through the urethra and into the bladder. Cysto-urethroscopy is used to diagnose and evaluate urinary tract disorders, such as infections, the presence of kidney or bladder stones, tumors in the bladder and more.
- Cystometry or a cystometrogram measures the bladder pressure while filling the bladder and performing certain maneuvers. Small catheters are placed through the urethra into the bladder and the bladder is filled with sterile water. Cystometry can help diagnose conditions such as overactive bladder, decreased bladder compliance, sensory urgency causing urinary frequency and decreased sensation of filling.
- Pressure-flow voiding studies are used to determine the ability of the bladder and urethra to properly expel urine. Sterile water is inserted into the bladder through a catheter. With the catheter in place, the patient urinates into a flow meter while the strength and resistance to pressure of the muscles in the bladder and urethra are determined.
- Urethral pressure profilometry is a procedure used to determine the urethral pressures which will sometimes guide surgical treatment.
- Video urodynamic testing gives physicians a visual look into the size and shape of the patient's urinary tract and is commonly used in cases of urine leakage or blocked urine flow. With the bladder full, X-rays are used to monitor the flow and path of a patient's urine.