Overactive bladder and incontinence part 4

Diagnosis

The diagnosis of an overactive bladder is generally made from the medical history. The physical exam may include evaluation of the prostate via a rectal exam. Urine is generally analyzed to ensure that there is no urinary tract infection. A neurological exam is done to identify any nerve defects.

There many tests which are used to assess overactive bladders. Some of the tests may include

Measurements of post void residual urine. In this test, one is asked to void and remaining urine in the bladder is measured. The test requires you have a small tube placed via the urethra (penis in male, and vagina in female) and into the bladder. Once you have voided, the tube is inserted and the residual urine volume is measured. The test is unpleasant because having a tube placed via the penis/vagina is absolutely not thrilling. Some health care workers now use ultrasound to measure the amount of urine remaining in the bladder

Uroflowmetry is a device that can measure volume and speed of voiding. This is then compared against other individuals and can be used to monitor progress of disease

Cystometry and pressure flow studies simply measure when the bladder will contract when it is filling with fluid. The bladder is filled with fluid and then another recording device measures activity of bladder muscles. The pressure which is developed to empty the bladder is measured.

Electromyography is a test to assess coordination of nerve impulses in bladder muscles and urethra. These sensors are placed on skin around the urethra and lower pelvis

Video urodynamics. This technique uses either x rays or ultrasound and combines one of the above studies to monitor active bladder filling and contraction. The fluid is a special dye that can be visualized on x ray

Cystoscopy involves inserting a small thin tube with a camera from vagina or penis into the urethra and in the bladder. This device is often used to check for anatomical defects, presence of stones or cancers
Once diagnosis of overactive bladder is made, there are several treatments available. The treatment usually starts with conservative care and lifestyle changes