History and Physical
To diagnose your problem, the physician first will ask questions about your medical history and symptoms. In particular, the physician will look for clues about the type of incontinence by noting your pattern of urination and urine leakage (when? how often? how severe?), as well as any symptoms of straining or discomfort when voiding. Also, you will be asked about your bowel habits. Because the intestines and urinary tract share a common support structure (the pelvic floor) and nerve supply, problems in one system may be associated with problems in the other. Additional clues to your diagnosis will include factors such as your history of illness, prior operations (especially procedures in the pelvic region), pregnancy (number of pregnancies, vaginal or cesarean births), sexual activity and use of medications. If possible, you should give your physician the following information:

• a list of all the medications you are currently taking (including nonprescription products)

• the dates and results of any surgical procedures or bladder-related tests that you've had

• a bladder record or voiding diary

Next, a physical exam will be performed to identify signs of medical conditions that could cause incontinence, such as stool impaction, poor reflexes or sensations (evidence of nerve problems), or tumors blocking the urinary tract.

To find out whether or not your bladder muscles are normal, the physician may measure your bladder capacity (amount of urine held by the bladder) and residual urine (amount of urine left in the bladder after voiding). The physician will ask you to drink a large amount of fluid and then urinate into a measuring pan; afterwards, he or she will measure any urine that is left over in the bladder.

Even if your medical history and physical exam do not pinpoint your incontinence problem, they may suggest the additional tests that are needed. Below lists some of the diagnostics and tests a doctor may perform when beginning a diagnosis of urinary incontinence.

Urinalysis
Urinalysis is a test in which a urine sample is analyzed in the laboratory for signs of infection, blood, urinary stones or other abnormalities. A clean-catch (midstream) or catheterized urine sample should be obtained for this study. Sometimes a urine culture is performed to determine the type of infectious organisms that may be present in the urinary tract. Urinary Tract Infection (UTI) is defined as a urine sample that contains bacteria in the amount of 105 CFU/ml or more. If blood, glucose (sugar), or protein are also present in the urine sample, further testing is indicated.

Q-Tip Test
The Q-tip test is a simple procedure that helps the physician to measure the degree of hypermobility (dropping down) that occurs in a patient's urethra and bladder neck during urination. Although subjective and nonspecific, this test may be useful for the diagnosis of stress incontinence.