Stress incontinence

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Anterior vaginal wall repair	Female urinary tract	Male urinary tract	Stress incontinence
Stress incontinence

Incontinence - stress

Involuntary loss of urine is the main symptom. It may occur when:

• Coughing
• Sneezing
• Standing
• Exercising
• During other physical activity

The health care provider will perform a physical exam, including a rectal exam, a genital exam in men, and a pelvic exam in women. In some women, a pelvic examination may reveal that the bladder or urethra is bulging into the vaginal space.

Tests may include:

• Post-void residual (PVR) to measure amount of urine left after urination
• Urinalysis or 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, the patient is asked to exercise -- following exercise, the pad is re-weighed to determine the amount of urine loss)
• A pelvic or abdominal ultrasound
• X-rays with contrast dye of the kidneys and bladder
• Cystoscopy (inspection of the inside of the bladder)
• Urodynamic studies (tests to measure pressure and urine flow)
• Rarely, an EMG (electromyogram) is performed to study muscle activity in the urethra or pelvic floor

Other tests may include the measurement of the change in the angle of the urethra when at rest and when straining (Q-tip test). An angle change of greater than 30 degrees often means there is significant weakness of the muscles and tissues that support the bladder.

Review Date: 05/15/2006
Reviewed By: Melanie N. Smith, M.D., Ph.D., Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.