Medical History and Physical Exam for Urinary Incontinence in Men
A medical history is the most important part of the examination for urinary incontinence. During the medical history, your doctor will ask you to describe:
- How long you have had incontinence.
- What, if anything, you are doing (laughing, coughing, or changing posture) when you experience incontinence.
- How often you have the problem and how much urine you lose.
- Risk factors you may have, such as ongoing (chronic) Reference bladder infections Opens New Window or Reference prostatitis Opens New Window, that could lead to incontinence.
- Your eating habits.
- Your bowel habits, to find out whether chronic constipation may be contributing to incontinence.
- Prescription and nonprescription medicines you take.
- Treatments for previous problems affecting your urinary tract.
- Your use of pads or other protective devices to control urine loss.
- How much caffeine, alcohol, and other fluids you drink daily.
Your doctor will ask questions about your general health and specific questions about your urinary and reproductive tracts, intestines, and Reference nervous system Opens New Window to find clues to the cause of the incontinence. He or she will also ask about conditions that are related to incontinence, including:
- Reference Prostate cancer Opens New Window.
- Enlarged prostate (Reference benign prostatic hyperplasia, or BPH Opens New Window).
- Pelvic surgery.
- Reference Diabetes Opens New Window.
- Reference Glaucoma Opens New Window.
- Reference High blood pressure Opens New Window.
- Reference Depression Opens New Window.
- Reference Heart failure Opens New Window.
- Reference Multiple sclerosis Opens New Window.
- Reference Amyotrophic lateral sclerosis (ALS) Opens New Window.
- Reference Parkinson's disease Opens New Window.
- Reference Stroke Opens New Window.
- Spinal cord injuries.
- Degenerative disc disease.
- Previous treatment of urinary incontinence.
Symptoms and conditions that often are related to incontinence also will be investigated, such as:
- A need to urinate frequently.
- A sudden, strong need to urinate.
- An inability to urinate.
- A blocked urine stream.
- A loss of urine while sleeping.
- Signs or symptoms of a Reference urinary tract infection Opens New Window, Reference prostatitis Opens New Window, or Reference enlarged prostate Opens New Window.
A physical exam often includes a thorough abdominal, Reference rectal, and genital examination. The doctor:
- Looks for growths such as tumors in the pelvic area.
- Checks for an enlarged prostate or reduced anal muscle tone.
- Checks to see whether a nervous system problem is causing muscle weakness or loss of reflexes.
Why It Is Done
A history and physical exam are usually done for everyone who sees the doctor about urinary incontinence.
- No growths or physical abnormalities are found.
- The prostate is not enlarged, and there is no evidence of prostate cancer.
- There is no abnormal muscle weakness or reflex loss because of a nerve problem.
- You do not have constipation.
- You have pain or discomfort when the doctor presses on the back or abdomen. This may suggest:
- A Reference urinary tract infection Opens New Window.
- A bladder that is full (urinary retention). A catheter (a thin, hollow tube) may need to be inserted to allow urine to flow out of the bladder.
- You have an enlarged or very firm prostate gland, which may point to Reference benign prostatic hyperplasia (BPH) Opens New Window or Reference prostate cancer Opens New Window. For more information, see the topics Reference Benign Prostatic Hyperplasia (BPH) and Reference Prostate Cancer.
- Growths or abnormalities were detected during the rectal exam that may be blocking the urinary tract. Reference Ultrasound Opens New Window or Reference computed tomography Opens New Window (CT scan) may be recommended.
- Other areas of the body, in addition to the urinary tract, show a loss of muscle control or signs of Reference Parkinson's disease Opens New Window or Reference stroke Opens New Window. For more information, see the topics Reference Parkinson's Disease and Reference Stroke.
What To Think About
The medical history is very important and can determine some causes of incontinence.
Be certain to tell your doctor about all prescription and nonprescription medicines you are taking.
The physical exam sometimes can identify abnormalities in the prostate, abdomen, or nervous system that may be causing incontinence or contributing to it. Findings from the physical exam help your doctor know whether further testing is needed.
|By:||Reference Healthwise Staff||Last Revised: July 17, 2012|
|Medical Review:||Reference E. Gregory Thompson, MD - Internal Medicine
Reference Avery L. Seifert, MD - Urology