Physical examination

The doctor or healthcare adviser will do a physical examination. They'll feel your stomach or abdomen for lumps and place pressure around that area to see if you feel any pain.

He or she might examine the muscles in the pelvic area. This will involve putting gloved fingers into the vagina or anus and asking you to squeeze your pelvic floor muscles. This will help determine whether you've got any pelvic floor or muscle strength problems.

This digital examination can also help find any abnormality in the structure of the vagina or rectum, such as a prolapse or signs of a tumour.

They might also have a look at your pelvic or vaginal area and back passage. This is to see if there's any scarring from tears or cuts, such as that caused by childbirth or surgery.

This physical examination might also test your reflexes to see if there's any nerve damage.

Pad test

This is when you're asked to use continence pads for a day or two and to keep track of how many you use and how wet they get. It can help identify the type and degree of incontinence.

Urine and lab tests

Urinary tract infections and haematuria (blood in the urine) are tested by taking a sample of urine and sending it to a laboratory for examination.

Haematuria can have many causes, ranging from the insignificant to the serious. A urine test will help find out why the blood is there.

A dipstick test, involving a specially coated piece of paper that is dipped into urine, can also test for signs of infections or blood.

Tests that examine cells, such as those found in urine, other fluids or tissue, are called cytology. As well as testing for cancers, cytology is used to find out about inflammatory diseases in the urinary tract.

A biopsy sample may also be taken from the bladder, kidney or ureter. This is when a small piece of tissue is removed and examined under a microscope. This is used to test for cancer and other conditions.

Bladder tests

Urodynamic tests are used to find out about how well the bladder's working. You’ll need to have a full bladder when you start the test.  

Uroflowmetry tests your urine flow: how much and how fast. First you’ll empty your bladder in a toilet that's fitted with a measuring device and a pan. This is done in a private room. Results are given in a graph.

Cystometry measures your bladder pressure during the storage and evacuation (emptying) phases. A catheter (thin tube) is inserted into your bladder through the urethra.

The residual urine (amount left) in the bladder and the pressure are both recorded. Then water or another fluid or gas is put into the bladder. Pressure in the bladder is then measured.

This helps to see how much the bladder can hold, when you feel the urge to go to the toilet, and if you leak urine. The test shouldn't hurt but will probably be uncomfortable.

Other tests

Intravenous pyelogram helps see into the kidneys, bladder and ureters. It's used to check for abnormalities, such as stones (small hard masses). Dye is injected into a vein and makes its way to the kidneys, ureters and bladder. X-rays are taken as the dye progresses through the system giving detailed pictures that help specialists see the organs.

Cystography is a test that also uses X-rays and dyes, but it's used to look at the bladder and the structures around it. A catheter is put into the bladder and dye is injected into it. X-rays of the bladder when full and during stages of emptying are taken.

The test helps urologists study the bladder in detail and find out if there's an obstruction, such as bladder stones or polyps (small bulging lumps in the tissue).

Cystoscopy is a test that uses a thin tube with a light and a miniature fibre-optic telescope. It's used to see into the urethra and the bladder. It's inserted into the urethra and can be flexible or rigid.

Ultrasound and magnetic resonance imaging (MRI) are other ways to look at the bladder, kidneys and ureters. Ultrasound uses the echoes from sound waves against structures such as organs to build up pictures of the body's interior. MRI uses magnets and radiowaves to create pictures. Neither involve radiation.