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It's usually clear from your symptoms whether you have stress incontinence. But your doctor will ask you questions and may do some tests to find out what's causing your symptoms.

Your doctor may then refer you to a doctor specializing in the treatment of stress incontinence. This might be a urologist (a doctor with specialist knowledge of the parts of your body that make, carry and store urine) or a gynecologist (a doctor with specialist knowledge of the womb).

You may also be referred to a physical therapist who specializes in teaching Kegel exercises (pelvic floor exercises). You could go to a continence clinic to try simple treatments for stress incontinence that don't involve surgery.

Your doctor may ask you about:¹

• Your symptoms
• Illnesses you've had
• Medications you've taken
• Surgery you've had
• Your pregnancies and experience of childbirth.

You may be advised to keep a diary for a week or a frequency and volume chart. You'll write down when you go to the bathroom, if you leak any urine and what you drink. Your doctor may also ask you to measure how much urine you pass in 24 hours. To do this, you can use a special pan that fits over the rim of your toilet.²

Your doctor may also ask you to write down how many pads you use each day or how wet they get over a number of hours. This tells your doctor how much urine you're leaking.² It's called a pad test.

Your doctor may examine the area around your vagina and rectum for medical conditions that can cause incontinence. For example, a tumor or bad constipation can cause incontinence. Also, if you have poor reflexes and feeling in this area, it can mean that your nerves are damaged.^{1 2}

Your doctor may send a sample of your urine to be tested in a laboratory. This checks for signs of infection or another problem.²

These are tests to check how well your bladder is working. They're usually done before you have surgery for incontinence. They can tell if you also have another type of incontinence or if there are any other complications. This information will help you and your doctor choose the right treatment for you.

A uroflowmetry test measures how much urine you pass and how fast it comes out. To do this, you pass urine into a toilet that has a pan to catch your urine, and a measuring device. You do this in private. A graph shows how fast your urine came out and helps your doctor tell if your bladder is working normally.

This test measures how much liquid your bladder can hold and the pressure inside your bladder. A doctor or nurse will put a small tube called a catheter into your bladder to empty it. Then a smaller tube is used to fill your bladder with water. Another tube is usually put into your rectum to measure the pressure there as well. You'll be asked how you feel as your bladder gets full and when you get the urge to pass urine. And you may be asked to cough to see if you leak any urine. This test may be slightly uncomfortable, but it shouldn't hurt.³

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.