What is the role of urinalysis and urine culture in the workup of urinary incontinence?

Updated: Jan 22, 2021
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Urinary tract infection (UTI) can cause irritative voiding symptoms and urge incontinence. UTI can cause or contribute to urinary incontinence disorders in several ways. Local inflammation can serve as a bladder irritant, causing uninhibited bladder contractions. Endotoxins produced by some bacterial strains can have an alpha-blocking effect on the urethral sphincter, thereby lowering intraurethral pressures.

Postmenopausal women are especially susceptible to these effects on the urethra and bladder. Hypoestrogenism may enhance the effects. Postmenopausal women with UTI may present without the classic symptoms of irritation and pain. The predominant symptom in some patients may be the onset or the worsening of urge urinary incontinence.

A screening urinalysis is generally recommended as part of the testing of women for urinary incontinence. In postmenopausal women, a urine culture should also be done. Cultures may show bacterial growth in patients whose urinalysis shows little or no evidence of inflammation. Colony counts of less than 105/mL may be of significance in postmenopausal women and merit treatment.

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