How is Incontinence Diagnosed?

Incontinence is a problem that affects nearly 13 million Americans each year and is most common in older individuals. You are not alone! It can be an uncomfortable topic to discuss but it is important to find the best means to provide comfort and safety to your aging loved one.

Finding the best way and time to discuss incontinence can be challenging, but the reward and benefits are well worth it. You can learn more about how to do this as a caregiver in our recent blog post: Caregivers Guide to Incontinence.

Incontinence can be caused by a multitude of reasons in men, such as an enlarged prostate, obstructions, neurological disorders, and, most frequently, decreased bladder capacity with aging. (Source:

The Incontinence Questionnaire

If you are unsure if your loved one has incontinence (urinary or fecal (or bowel), then pay attention and answer the following standard questions. These could be used by observation or in a conversation with your aging loved one. If the answer is yes to any of the questions, then it may be due to a bladder or bowel issue.

  • When you have to go, do you rush to the toilet?
  • Do you feel you are not empty after going to the bathroom (relieving your bladder or bowels)?
  • Do you experience frequent leakage before you get to the toilet?
  • Do you strain (mild, medium or heavy) when emptying your bowels?
  • Do you leak regularly (lifting something, exercising, sneezing, coughing, laughing, etc.)?
  • Do you notice soiled underwear regularly?
  • Do you wake up more than twice to go to the bathroom at night?

This is not an exhaustive list and there are many other conditions that may identify incontinence. The great news is there are many ways to treat and manage your incontinence.

What is Incontinence?

Urinary incontinence (UI) is the involuntary loss of urine. It is common with older adults and the types vary from: Stress (physical pressure), urge (difficulty emptying), functional (physical or mental conditions), mixed or a total loss of control.

Bowel (fecal) incontinence is the inability to control your bowel movements. This often will lead to liquid stool that is then hard to control and can leak out. This is also true of solid leakage as well.

How Is Incontinence Diagnosed?

After you run through the questionnaire above and discuss incontinence with your physician, the next step is a diagnosis and determination of the cause of your urinary or bowel incontinence. To do that, your doctor will conduct a physical exam, and discuss your current health, lifestyle environment, and other important items such as:

  1. How much do you drink?
  2. How often you urinate and have a bowel movement?
  3. How often you leak urine or bowel?

To prepare for your visit, take note of these items for at least a week prior.

At your visit, your physician may conduct some easy tests to search out the bladder control problem. One common test is having you cough while you are standing to see if you leak any urine. Beyond this common visual test, your doctor may run through any number of the following:

Urinalysis and urine culture: These tests show whether you have a urinary tract infection (UTI) or blood or sugar in your urine.

Bladder stress test: It simulates the accidental release of urine that may occur when you cough, sneeze, laugh, or exercise.

Pad test: A pad is weighed and measured regularly to see if there is an increase in weight from leakage.

X-rays or ultrasounds: These are used to examine changes in the position of the bladder and urethra when you urinate, cough, or strain.

Conducting any of these tests, or more invasive ones if needed, will help to identify the primary cause of your incontinence issues. With this identified, you are able to focus your energies on ways to treat and manage your incontinence. It will also help you know what to expect and focus on the best underwear to support your daily life.

Key Ways to Treat and Manage Incontinence

When dealing with incontinence, there are many ways to treat, manage or possibly stop it. Some of the fundamental ways to do this are:

  • Do pelvic floor exercises
  • Quit smoking
  • Avoid lifting heavy objects (especially improperly)
  • Lose excess weight
  • Deal with constipation immediately
  • Reduce the intake of caffeine and alcohol
  • Stay hydrated
  • Eat a nutritional diet
  • Take medication (only prescribed by a physician)
  • Have a surgical procedure
  • Have Botox injections to tighten the muscles to contract
  • Use incontinence underwear and other products

These are not the only means to address urinary and bowel incontinence; however, this is a good list to work through to see what, if any, can directly help your aging loved one. Start at the top of the list and work down to identify which one(s) directly affect you.

Brooke worked as a home health and hospice nurse for many years. During her time working with patients and families, she saw the pressures and strain of what caregivers went through while caring for loved ones. Lack of resources to help caregivers prompted her to start a support group for caregivers in her area. Since then Brooke has turned to writing courses for nurses and content writing. In her spare time, she enjoys time with family, her dog and travel.