Evaluation of Female Urinary Incontinence

, , University of Texas Medical School

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Simple Clinical Tests

Urinalysis. Although incontinence is not caused by UTI, being incontinent, especially severely incontinent, is a predisposing factor in developing UTI. Incontinent women have a higher incidence of UTI.[16]

Residual urine. Residual urine measurement is necessary to determine the efficiency of bladder emptying prior to any therapeutic intervention. Therapeutic drugs that interfere with bladder contractility may lessen detrusor instability or hyperreflexia at the expense of exacerbating voiding dysfunction. After surgical correction of incontinence, it may no longer be possible to void by straining, resulting in the need to re-learn to void by pelvic-floor relaxation and bladder contraction. If contractility has been impaired, intermittent catheterization may be necessary. Either ultrasound or urethral catheterization may be used to determine residual urine.

Voiding chart. A voiding chart is a simple record of bladder volumes, the times of voiding, and the number of incontinence episodes. This provides both the patient and doctor with a baseline assessment of frequency, nocturia, and urine volumes. This tool may be used to monitor improvement in continence, especially when it is associated with frequency. It is particularly valuable for monitoring improvement in conditions such as interstitial cystitis, in which urgency and frequency may be the predominant symptoms.

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