@Article{,
AUTHOR = {E. Ann Gormley},
TITLE = {Evaluation of the patient with incontinence},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {14},
YEAR = {2007},
NUMBER = {Suppl.6},
PAGES = {58--62},
URL = {http://www.techscience.com/CJU/v14nSuppl.6/63322},
ISSN = {1488-5581},
ABSTRACT = {The incontinent patient is evaluated in order to make a
presumptive diagnosis so that treatment can be offered. The
evaluation begins with a history and a physical examination.
The history focuses on the description of the patient’s
incontinence. Assessing the patient’s bother and
determining their expectations of treatment may further
guide how aggressive one needs to be both with the
evaluation and the presentation of treatment options. The
important parts of the physical exam are an examination of
the abdomen and pelvis including a provocative stress test.
A urinalysis and a post-void residual (PVR) should be
performed in all incontinent patients.<br/>
Incontinence questionnaires, voiding diaries, and pad weight
tests can provide more objective data than the history alone.
Upper tract imaging is indicated in the patient with a history
of hematuria and in patients with suspected
hydroureteronephrosis. Other imaging may be useful to
further evaluate other suspected pelvic pathology.
Urodynamics are performed to determine if the incontinence
is due to bladder or urethral dysfunction or both, to assess if
the patient has a storage or emptying problem and lastly in
an effort to identify patients whose upper tracts are at risk
due to high bladder storage pressures. Cystoscopy is
indicated in the work up of some incontinent patients.<br/>
The evaluation of the incontinent patient consists of a
history, a physical, urinalysis and a post-void residual.
Optional evaluative tests consist of a variety of
urodynamic tests, imaging studies and cystoscopy.},
DOI = {}
}