Physical examination will include examination of the abdomen and rectum. Women will also have a pelvic exam; men will also have a genital exam. In most cases the physical exam reveals nothing abnormal. If there are neurologic causes, other neurologic abnormalities may be found.
Tests include the following: - post-void residual (PVR) to measure amount of urine left after urination
- urinalysis/urine culture to rule out urinary tract infection
- urinary stress test (the patient is asked to stand with a full bladder and then cough)
- pad test (after placement of a pre-weighed sanitary pad, patient asked to exercise; following exercise, the pad is weighed to determine urine loss)
- a pelvic or abdominal ultrasound
- X-rays with contrast dye
- cystoscopy (inspection of the inside of the bladder)
- urodynamic studies (tests to measure pressure and urine flow)
- EMG (myogram) (rarely)
Further tests will be performed to rule out other types of incontinence. These tests may include the "Q-tip test," which measures the change in the angle of the urethra while at rest and when straining. An angle change of greater than 30 degrees often indicates significant weakness of the muscles and tendons that support the bladder, which is common in stress incontinence.
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