Topic: Urinary Incontinence in Men
Question: How to diagnose Urinary Incontinence in Men ?
Answer: Men should tell a health care professional, such as a family practice physician, a nurse, an internist, or a urologista doctor who specializes in urinary problemsthey have UI, even if they feel embarrassed. To diagnose UI, the health care professional will
                
- take a medical history  - conduct a physical exam  - order diagnostic tests
                
Medical History
                
Taking a medical history can help a health care professional diagnose UI. He or she will ask the patient or caretaker to provide a medical history, a review of symptoms, a description of eating habits, and a list of prescription and over-the-counter medications the patient is taking. The health care professional will ask about current and past medical conditions.
                
The health care professional also will ask about the mans pattern of urination and urine leakage. To prepare for the visit with the health care professional, a man may want to keep a bladder diary for several days beforehand. Information that a man should record in a bladder diary includes
                
- the amount and type of liquid he drinks  - how many times he urinates each day and how much urine is released  - how often he has accidental leaks  - whether he felt a strong urge to go before leaking  - what he was doing when the leak occurred, for example, coughing or lifting  - how long the symptoms have been occurring
                
Use the Daily Bladder Diary to prepare for the appointment.
                
The health care professional also may ask about other lower urinary tract symptoms that may indicate a prostate problem, such as
                
- problems starting a urine stream  - problems emptying the bladder completely  - spraying urine  - dribbling urine  - weak stream  - recurrent UTIs  - painful urination
                
Physical Exam
                
A physical exam may help diagnose UI. The health care professional will perform a physical exam to look for signs of medical conditions that may cause UI. The health care professional may order further neurologic testing if necessary.
                
Digital rectal exam. The health care professional also may perform a digital rectal exam. A digital rectal exam is a physical exam of the prostate and rectum. To perform the exam, the health care professional has the man bend over a table or lie on his side while holding his knees close to his chest. The health care professional slides a gloved, lubricated finger into the patients rectum and feels the part of the prostate that lies in front of the rectum. The digital rectal exam is used to check for stool or masses in the rectum and to assess whether the prostate is enlarged or tender, or has other abnormalities. The health care professional may perform a prostate massage during a digital rectal exam to collect a sample of prostate fluid that he or she can test for signs of infection.
                
The health care professional may diagnose the type of UI based on the medical history and physical exam, or he or she may use the findings to determine if a man needs further diagnostic testing.
                
Diagnostic Tests
                
The health care professional may order one or more of the following diagnostic tests based on the results of the medical history and physical exam:
                
- Urinalysis. Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container at home, at a health care professionals office, or at a commercial facility. A health care professional tests the sample during an office visit or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color to indicate signs of infection in urine.  - Urine culture. A health care professional performs a urine culture by placing part of a urine sample in a tube or dish with a substance that encourages any bacteria present to grow. A man collects the urine sample in a special container in a health care professionals office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for culture. A health care professional can identify bacteria that multiply, usually in 1 to 3 days. A health care professional performs a urine culture to determine the best treatment when urinalysis indicates the man has a UTI. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults.  - Blood test. A blood test involves drawing blood at a health care professionals office or a commercial facility and sending the sample to a lab for analysis. The blood test can show kidney function problems or a chemical imbalance in the body. The lab also will test the blood to assess the level of prostate-specific antigen, a protein produced by prostate cells that may be higher in men with prostate cancer.  - Urodynamic testing. Urodynamic testing includes a variety of procedures that look at how well the bladder and urethra store and release urine. A health care professional performs urodynamic tests during an office visit or in an outpatient center or a hospital. Some urodynamic tests do not require anesthesia; others may require local anesthesia. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely; they may include the following:      - uroflowmetry, which measures how rapidly the bladder releases urine    - postvoid residual measurement, which evaluates how much urine remains in the bladder after urination    - reduced urine flow or residual urine in the bladder, which often suggests urine blockage due to BPH
                
More information is provided in the NIDDK health topic, Urodynamic Testing.
(Source: NIDDK)