When you can't get through an episode of your favorite show without having to get up and visit the restroom, it's time to see the doctor to find out if you have an overactive bladder. Since many other conditions, such as interstitial cystitis or a simple bladder infection, can cause the same symptoms, thorough testing is necessary to rule out other problems that could spread or worsen without proper treatment. Multiple tests are usually needed, although many doctors only perform one test from each of the following categories to reach a diagnosis of overactive bladder.
Urologists and urogynecologists alike start by doing a basic physical exam of the pelvic area on patients who have inappropriate urges to go. Stress, weakness, or other issues with the many muscles surrounding the bladder and urethra can lead to unpleasant sensations that need a surgical or physical therapy remedy rather than medication. These physical exams also often include a cough test to see if the patient has any incontinence, another indicator of weak pelvic floor muscles. This is one of the most common and easy to remedy causes of an overactive bladder, but it's considered a separate condition from overactive bladder problems with no direct physical cause.
Aside from being caused by the muscles in the affected area, the sensations of needing to go when the bladder is empty could arise from neurological complications. It only takes pressure on one nerve in your spinal column or running through your hip to create a whole host of unpleasant and distraction sensations. Unless other symptoms specifically point to a neurological cause, most doctors simply use a generic reflex and sensory test to determine any unusual loss or increase in sensation. Electrostimulation tests may be ordered later if neurological causes are still suspected.
Since the urine itself could be irritating the bladder and causing the sensation of needing to empty it, a thorough urinalysis at a lab is necessary. Unusual levels of blood, ketones, serum, or other bodily waste products in the urine can indicate a secondary cause that needs separate treatment. This testing of the urine also rules out infection, and some people who think they are experiencing an overactive bladder actually have a low grade chronic infection that slips by the usual testing. Your doctor may have some of your urine sample cultured to see if bacteria grows in it over time to reveal a hidden infection that was going undetected.
Once the simpler tests listed above fail to reveal any secondary causes of the overactive symptoms, it's time to move onto the specialized tests that can most clearly determine why the bladder feels full when it's not. These are known as urodynamic tests because they study the flow of urine as it moves through your body. The tests in this category tend to be more complex, invasive, and uncomfortable, but they're all relatively short and necessary for a clear diagnosis so you can get proper treatment. Your doctor may schedule one or more of the following procedures to find out what's going on in your bladder:
- Uroflowmetry is a test in which you urinate into a special collection device that measures the total volume and the pressure of flow. Poor flow indicates you may not be fully emptying your bladder.
- Cystoscopy involves a tiny camera being inserted through the urethra to get a clear look at the inside of it and the bladder. Growths and damage to the inner lining of the bladder could be the cause of those urges to visit the bathroom.
- Cystometry is an advanced pressure test that can pinpoint nerve and muscle issues affecting your bladder. It involves having your bladder filled and emptied with a catheter while a sensor in the vagina or rectum records pressure readings throughout the pelvic area.
Contact a doctor from a clinic like Advanced Urology Associates to learn more.