It’s not unusual for people to be reluctant to speak with their doctor about bladder-related symptoms. But working with your doctor is important in getting a diagnosis and finding the right treatment.
To diagnose an overactive bladder (OAB), your doctor will likely ask you questions about your medical history and give you a physical exam and at least one test. Your doctor will probably request a urine sample for testing, and may refer you to a specialist for further evaluation and treatment. Read more about the symptoms of OAB.
Keeping a bladder diary
Your doctor will ask you questions about your symptoms as part of the diagnostic process. A bladder diary can provide useful information. This is something you can bring to your appointment. It will give your doctor details on your condition. To create a bladder diary, record the following information over the course of several days:
- Record everything you drink, how much, and when.
- Log when you urinate, how long it takes, and the time between each bathroom visit.
- Note the severity of the urgency you feel and if you experience involuntary loss of urine.
Physical exam and basic tests
Your doctor will perform a physical exam after discussing your symptoms. The exam might include one or more of the following tests:
Pelvic or prostate exam
During a female pelvic exam your doctor will examine you for any vaginal abnormalities and to see if the pelvic muscles needed for urination are in good condition. Your doctor will also check the strength of the muscle attachment in the vaginal region. Weak pelvic muscles can lead to urge incontinence or stress incontinence. Urge incontinence is usually a symptom of OAB, while stress incontinence is usually independent from OAB.
Your doctor will perform a neurological test to check your reflexes and sensory responses. The motor reflexes of muscles are checked because a neurological condition can cause OAB.
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 test can also help determine if your 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 OAB. The presence of bacteria may indicate a urinary tract infection (UTI). This condition can cause feelings of urgency. Frequent urination can also be a sign of diabetes.
Urodynamic 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. Then your doctor will insert a catheter into the bladder through your urethra. They 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 to measure capacity. It will also allow them to see how full your bladder gets before you feel the urge to urinate. Your doctor may give you an antibiotic before or after the tests 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’s an obstruction, such as a bladder stone.