It’s not unusual for people to be reluctant about speaking with their doctor about bladder-related symptoms. It can be an embarrassing topic. Working with your doctor is important in getting a diagnosis, ruling out other conditions, and finding the right treatment.
An overactive bladder (OAB) diagnosis will likely include questions about your medical history, a physical exam, and one or several tests. Your doctor will probably request a urine sample for testing, and you may be referred you to a specialist for further evaluation and treatment.
As part of the diagnostic process, your doctor will ask you questions about your symptoms. A bladder diary can provide useful information. This is something you can bring to your appointment that will give your doctor specific details on your condition. To create a bladder diary, record information about your intake and urination over the course of several days:
- Record everything you drink as well as how much and when.
- Log when you urinate, how long it takes, and the time between each visit to the bathroom.
- Note the severity of the urgency you feel and whether you experience an involuntary loss of urine.
Tests and Exams
After discussing your symptoms and concerns, your doctor will perform a physical exam. This might include one or more of the following tests.
Pelvic or Prostate Exam
A female pelvic exam is done to examine any vaginal abnormalities and to see if the pelvic muscles needed for urination are in good condition. This also checks to see if the muscle attachment in the vaginal region is strong enough to perform its functions. Weak pelvic muscles can lead to urge incontinence as a symptom of OAB or stress incontinence, which is usually independent from OAB.
In men, a prostate exam will determine whether an enlarged prostate is causing OAB symptoms.
Your doctor will perform a neurological test to check your reflexes and sensory responses. Because OAB can be caused by a neurological condition, the motor reflexes of muscles are checked.
Cough Stress Test
This test will rule out the possibility of stress incontinence, which is different from OAB. The cough stress test involves drinking fluids, relaxing afterward, and then coughing to see if stress or physical exertion causes urinary incontinence. This can also help determine if the bladder fills and empties like it should.
Your doctor will also have you provide a urine sample, which is checked for abnormalities. The presence of blood or glucose may point to conditions that have symptoms similar to those of OAB. The presence of bacteria may indicate a urinary tract infection, which can cause feelings of urgency. Frequent urination can also be a sign of diabetes.
These tests measure the bladder’s ability to empty properly. They can also determine whether the bladder is contracting involuntarily. Involuntary contractions can cause symptoms of urgency, frequency, and incontinence.
Your doctor will have you provide a urine sample by emptying your bladder. Then a long, thin tube (catheter) is inserted into the bladder through the urethra. Your doctor will measure the amount of urine left in your bladder after urination. Your doctor may also use the catheter to fill the bladder with water in order to measure capacity and to see how full the bladder must be before you feel the urge to urinate. Your doctor may give you an antibiotic before or after the tests in order to prevent infection.
During this test, you will urinate into a machine called an uroflowmeter. This device measures the volume and speed of urination. The peak flow rate is displayed on a chart and reveals whether the bladder muscle is weak or if there is an obstruction such as a bladder stone.
Generally, a diagnosis of OAB takes only one doctor’s visit. However, your doctor will use the additional tests to determine what exactly is causing the OAB. This will assist in determining the best course of treatment to pursue.