Male Incontinence

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Diagnosis

To diagnose male urinary incontinence, the physician usually takes a medical history, performs a complete physical examination, and performs diagnostic tests. Patients may be asked to complete a voiding diary. When benign prostatic hyperplasia (BPH, enlarged prostate) is suspected, the physician may assess symptoms using the Prostate Symptom Score developed by the American Urological Association (AUA).

A voiding diary, also sometimes called a bladder diary or urination diary, is a record of fluid intake (including type and time consumed) and voiding (including information about time of urination, strength of the urge, urine volume, and amount of any leakage). This information can be used to help diagnose the type of urinary incontinence and determine if other tests are needed.

A medical history includes information about past and recent illnesses or surgeries, information about symptom onset, and information about any additional symptoms (e.g., pain, muscle weakness). Information about prescription and over-the-counter medications, fluid intake, and alcohol and caffeine consumption is also important.

The physical examination includes an evaluation of the abdomen, rectum, genitals, and pelvis, and digital rectal exam (DRE) to check for an enlarged prostate. In some cases, a neurological exam also is performed to help diagnose nerve disorders or other neurological conditions that can cause male incontinence.

Other diagnostic tests may be used to detect an underlying medical condition. These tests include the following:

• Blood tests
• Electroencephalogram (EEG)
• Electromyogram (EMG)
• Imaging tests (e.g., x-rays, ultrasound)
• Urinalysis (to detect infection, kidney disease, and diabetes)
• Urodynamic testing

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