How is overactive bladder diagnosed?

In the diagnosis of overactive bladder, the doctor may start by asking you about your symptoms and medical history. You may then have a physical exam with attention to your genital region and abdomen. You may have to give a urine sample which can be analyzed for signs of infection or kidney troubles.

There are several other tests that may be used to better characterize your bladder problems. After you have emptied your bladder, a small amount of urine, called the post void residual volume, remains. In certain types of incontinence, the post void residual volume is large, causing symptoms similar to those of overactive bladder. The doctor can determine the post void residual volume by putting a small, flexible tube called a catheter, into the bladder via the urethra. Any urine present is drained and the amount measured.

Cystometry is another type of test that measures the relationship between the pressure in your bladder and the flow of urine. Any abnormal muscle contractions caused by overactive bladder will be detected by the pressure sensor. This can be combined with imaging via ultrasound or x-ray, so that the doctor can view your urinary system during the testing.

Another type of test, called electromyography, actually measures the nervous system activity around your bladder. Finally, the doctor may use cystoscope, a very small lens placed on a flexible plastic tube that creates a magnified picture of the insides of your urinary system, to view your urethra and bladder more directly.