Do You Need an Incontinence Assessment? Here’s What to Expect

If you ever experience urine leaks (even infrequently), it could be a sign that you're suffering from urinary incontinence. A professional incontinence assessment is the most effective way to receive a diagnosis, determine the causes, and devise a treatment plan to manage your symptoms.

In this article, we'll be taking a closer look at urinary incontinence and what you can expect from an assessment.

Signs You May Need a Continence Assessment

Some of the main symptoms of urinary incontinence include:

• Leaking urine when you cough, sneeze, or exercise

• Leaking urine uncontrollably

• Wetting the bed

• You can't empty your bladder fully when you go to the toilet

• Feeling an uncontrollable urge to go to the toilet

If you're experiencing any of the above symptoms, you should try to book a continence assessment with your general practitioner as soon as possible.

A Closer Look at Urinary Incontinence

Urinary incontinence happens when you experience a loss of urinary control, usually resulting in unintentional urine leaks. It can be caused by a wide variety of factors, including ageing, pregnancy, weakened pelvic floor muscles, and urinary tract infections.

There are five main types of urinary incontinence, including:

• Stress incontinence - caused by pressure on the bladder when you cough, sneeze, laugh, exercise etc.

• Urge incontinence - preceded by a sudden and uncontrollable urge to pass urine.

• Mixed incontinence - a mixture of stress and urge incontinence.

• Functional incontinence - you fail to reach the toilet due to a physical or mental impairment.

• Overflow incontinence - you experience leaking or 'dribbling' because you can't empty your bladder fully.

What about faecal incontinence?

Faecal incontinence, also known as bowel incontinence, happens when you lose control of your bowel movements. Symptoms typically include faeces leakage. If you suffer from both faecal and urinary incontinence, this is referred to as double incontinence.

What You Can Expect From an Incontinence Assessment

The details of your incontinence assessment will depend on your general practitioner, your medical history, and where you live. However, here are a few things you can expect:

Questions about your medical history

Most incontinence assessments begin with a discussion about your medical history, including:

• Whether or not you've ever been pregnant

• If you've ever experienced any type of abdominal trauma

• Your other medical conditions

• The types of medications that you are currently on

You may also be asked about your lifestyle, including your diet and how often you exercise. It is important to remain truthful if you want an accurate diagnosis. Once this information has been collected, you can move on to the next part of the assessment.

History

Most of the time your GP can diagnose the type of incontinence you are experiencing by taking a thorough medical history. This will involve asking you about your symptoms and your medical history. After this examination and scans are normally just helpful for confirmation and to rule out any rarer conditions.

Physical examination

Your GP may need to do a physical examination if they are concerned about a potential prolapse or weak pelvic floor muscles. A physical examination is not always needed.

Physical examinations may require you to undress from the waist down. Your GP will usually examine your pelvic area, and you may be asked to cough to see whether or not you leak any urine or have a prolapse. Your GP may also insert their finger into your vagina to test the strength of your pelvic floor muscles

Through this examination, your GP should be able to determine if there are any physical or anatomical reasons for your incontinence. This assessment can seem embarrassing but it's typically painless and quick, so there is nothing to worry about. You can always ask for a chaperone or ask to skip the examination if you really don’t want to do it.

Dipstick test

Urinary tract infections can cause symptoms including temporary incontinence. If your GP thinks you may have a UTI, you'll be asked to provide a urine sample, which will be tested for bacteria. The dipstick test is very quick and effective, and it can also test for both protein and blood in your urine. The sample may also be sent to a laboratory to see if it grows any bacteria.

If your results are positive for a UTI, your infection will be treated. If you still experience incontinence symptoms after your infection has cleared up, your GP will have to look at other potential causes. Recurrent UTIs can indirectly predispose you to a future problem with incontinence.

Residual urine test/ voiding scan

Residual urine tests (voiding scan) are performed on those who are suspected to suffer from overflow incontinence. In most cases, you will be asked to pee (void your bladder) and then an ultrasound scan will be taken of your bladder to see how much urine is still left in it.

Sometimes, your remaining urine will be drained using a catheter, which is inserted into your urethra (the tube you pee from). This can help provide an accurate estimation of how severe your overflow incontinence is.

Specialist Tests

Some tests are performed after you’ve been referred to a specialist. Bear in mind that you may not have to do these tests if you are experiencing incontinence. Often these tests are done for other bladder conditions. However, for your information, we will explore these below.

Urodynamic tests

Urodynamic tests refer to a group of assessments performed to determine the functionality of your bladder and urethra. They typically include measuring the pressure in your bladder, measuring the flow of your urine, and measuring your abdominal pressure.

The results from these tests help your specialist determine the causes and the severity of your incontinence.

Cystoscopy

A cystoscopy is a slightly more complex procedure in which a thin tube with a camera is used to look inside your bladder and surrounding areas. This procedure is used to help identify any abnormalities and is incredibly useful in diagnosing any bladder-related issues.

The area will be numbed with either numbing cream or anaesthetic before the procedure begins. Cytoscopies are often seen as a 'last result' when all other assessments have already been ruled out.

What Happens After the Assessment?

Once your GP has determined the cause of your incontinence, as well as what type of incontinence you're dealing with, they will be able to provide you with a diagnosis. From there, they will help create a treatment plan for you and provide you with tips to manage your symptoms. Often this involves referring you to a bladder and bowel clinic and creating a plan which could include:

Treating underlying causes

If your incontinence symptoms are caused by underlying medical conditions, these conditions will be treated to indirectly treat your urinary incontinence. For example, if your incontinence is due to menopause, you may consider HRTs in order to minimise your symptoms.

Avoiding trigger foods

Did you know that certain foods can worsen your urinary incontinence symptoms? The types of foods and beverages you should try to avoid include alcohol, acidic food, artificial sweeteners and caffeine. Instead, opt for nutritious meals that promote bladder health.

Pelvic floor exercises

You can strengthen your pelvic muscles and gain better bladder control by practising pelvic floor exercises. These exercises typically involve contacting and relaxing the muscles surrounding your bladder. To get a personalised plan, it is best to do pelvic floor exercises under the guidance of a pelvic floor physiotherapist.

Keep a bladder diary

A bladder diary acts as an important tool to help you determine whether or not your symptoms are improving. You can use this diary to write down how often you have to use the bathroom, how much water you drink each day, and measure the amount of urine you pass. This info can be incredibly useful for your GP.

Using continence products

These days, there are plenty of continence products out there that aim to help you lead a normal life. For example, our bamboo pads are designed to hold approximately five teaspoons of urine, keeping you dry throughout the day. You could also make use of leak-proof underwear and waterproof mattress covers.

Bladder training

Bladder training involves holding your pee and only going to the bathroom at set intervals. This can also help you strengthen your pelvic muscles and reduce your urges over time. As time goes on, you can make these intervals longer and longer. It is best to do bladder re-training under the supervision of a healthcare professional.

Injections and surgical options

If none of the lifestyle changes end up working out for you, you could be a candidate for injections or other surgical options. Your GP will have to refer you to a urologist to help you discuss these options and determine which path is right for you.

FAQs

What can you do to prevent urinary incontinence?

While urinary incontinence is not always preventable there are things you can do to reduce the risk. This includes completing pelvic floor exercises regularly and practising healthy bladder habits. This includes not having “just-in-case” pees, not holding in your urine for long periods and avoiding a diet heavy in bladder irritants.

What are some of the most common underlying medical conditions to cause urinary incontinence?

• Diabetes

• Dementia

• Menopause

• Obesity

• Recurrent urinary tract infections

• Urinary stones

At what point should I see a doctor regarding my incontinence symptoms?

You should make an appointment with your GP when you notice the first signs of incontinence. The sooner you get a proper diagnosis, the sooner you can find a treatment plan that works for you.

Final Thoughts

Urinary incontinence can come with many frustrating symptoms that the people affected by it often feel embarrassed about. However, there are many effective ways to manage your condition and lead a normal life. With around 50% of adult women experiencing incontinence at some point in their lives, there is absolutely no reason to feel alone or ashamed.

Here at Jude, we are passionate about smashing stereotypes and spreading important information through informative articles like this one. We also have a range of specialised incontinence products, including leak-proof underwear, incontinence pads, and bladder support supplements.

With the right products and knowledge, you'll learn how to minimise your symptoms and go about your everyday life with confidence.