Your doctor reviews your medical background, including previous surgeries, childbirths, medications, and existing health conditions. This comprehensive review helps identify potential contributors to incontinence, such as diabetes, neurological disorders, or medication side effects.

A thorough physical assessment includes evaluation of the abdomen, pelvic organs, and rectum to check for abnormalities or masses affecting the urinary tract. In women, the examination may consist of assessment of pelvic organ prolapse and vaginal atrophy.

Patients record fluid intake, urination frequency, incontinence episodes, and associated activities for several days. This detailed log helps establish patterns and triggers, providing information about the nature and severity of the condition that may not be captured during a single office visit.

Laboratory testing of urine samples checks for infection, blood, abnormal cells, and other indicators of urinary tract disorders. These tests can identify conditions such as urinary tract infections or diabetes that may cause or exacerbate incontinence, allowing for targeted treatment.

This test measures the amount of urine remaining in the bladder after urination using either ultrasound imaging or catheterisation. Elevated residual volumes may indicate obstruction or poor bladder muscle function, which helps differentiate between various types of incontinence.

Specialised evaluations measure bladder pressure and flow during filling and emptying. These tests assess how well the bladder, sphincters, and urethra store and release urine, providing detailed information about bladder function and the specific nature of the incontinence.

• Behavioural techniques: Timed voiding and bladder training help patients develop regular urination schedules and gradually increase the time between bathroom visits. These methods teach the bladder to hold urine longer and reduce urgency, potentially decreasing episodes of leakage when practised consistently.
• Pelvic floor exercises: Known as Kegel exercises, these involve repeatedly contracting and relaxing the pelvic floor muscles to strengthen them. Proper technique requires identifying the correct muscles by stopping urine mid-stream, then practising contractions regularly throughout the day without using abdominal, buttock, or thigh muscles.
• Medication therapy: Various medications target different types of incontinence. These medications work by relaxing the bladder muscle, preventing involuntary contractions, or improving tissue integrity in the urinary tract.

• Sling procedures: Synthetic or natural tissue strips create a supportive hammock under the urethra and bladder neck. This outpatient procedure typically takes 30-45 minutes and works by providing additional support to prevent leakage during physical activity.
• Bladder neck suspension: This procedure lifts and secures the bladder neck and urethra to the surrounding pelvic structures. The surgeon places sutures either through an abdominal incision or using laparoscopic techniques, creating proper anatomical positioning to reduce stress incontinence.
• Prolapse repair: When incontinence is associated with pelvic organ prolapse, surgical correction of the displaced organs can simultaneously address urinary symptoms. The procedure restores the normal anatomical position of the bladder, uterus, or rectum, which may have been placing pressure on the urinary tract.