Urge incontinence

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Female urinary tract

Male urinary tract

Overactive bladder; Detrusor instability; Detrusor hyperreflexia; Irritable bladder; Spasmodic bladder; Unstable bladder; Incontinence - urge

• Sudden and urgent need to urinate (urinary urgency)
• Frequent urination, in the daytime and at night
• Abdominal distention or discomfort
• Involuntary loss of urine

A 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 or urine culture to rule out urinary tract infection
• Urinary stress test (the patient stands with a full bladder and coughs)
• Pad test (after placement of a pre-weighed sanitary pad, patient exercises, then pad is weighed to determine urine loss)
• Pelvic or abdominal ultrasound
• X-rays with contrast dye
• Cystoscopy (inspection of the inside of the bladder)
• Urodynamic studies (measurement of pressure and urine flow)
• EMG (myogram) - rarely needed

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 at rest and when straining. An angle change of greater than 30 degrees often indicates significant weakness of the muscles that support the bladder, which is common in stress incontinence.

Review Date: 06/13/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.