Bladder continence assessment
When you first visit your doctor, you may be asked a variety of questions about your toilet habits to find out what is wrong with your bladder, and to what degree. Talking about it is easier for some than for others.
If you find talking about your urinary continence problems a daunting prospect, remember that healthcare professionals often talk to people about bladder and bowel control. It's a normal part of their working day.
How do I talk about bladder control?
There are different ways to talk about your symptoms that will help the doctor, nurse or specialist assess your symptoms.
Use language and words that you feel comfortable with. Try to describe your bladder symptoms as accurately as you can. Talk about all your symptoms, not just one. For instance, you might have to go to the toilet a lot at night (called nocturia) and leak a little when you cough.
If you are feeling pain, try and describe what kind of pain it is, where you feel it and when it happens.
Talk about your symptoms
Do you feel pain before, during or after going to the toilet?
Do you have cramp or sharp pain?
Is it in your stomach or lower down in the vaginal area or scrotum?
When you go out, do you always locate the nearest toilet before doing anything else? This is called toilet mapping.
Does your urine have a strong smell?
Do you have to strain when peeing? Is it a strong flow or just a dribble?
Can you feel the sensation of fullness and an urge to go to the toilet?
When you get the urge to go, do you have to run for the toilet or can you wait and for how long?
If you leak, how often does it happen and how much leakage is there?
Talk about daily life
If you prefer to tell the doctor about your bladder problems in another way, you can talk about how your bladder symptoms affect your quality of life.
Do you have to do a lot of laundry because of leakage?
Does the problem affect your relationships?
Do you avoid going out in case of an accident?
When you do go out, do you always locate the nearest toilet before doing anything else? This is called toilet mapping.
You'll be asked about your medical history, such as if you've had surgery, if you are taking any medicines and if you have any conditions, such as diabetes or recurring bladder infections. Women will be asked about their experience of childbirth.
- You'll be asked about your toilet habits: how often you go to the toilet and if you have any toilet access restrictions; whether you feel fullness in your bladder and if you have to run for the toilet.
- You'll be asked if you leak and when (for instance, when you cough or laugh, or during sex); if you ever leak without knowing.
- You'll need to tell your doctor or healthcare professional if you use continence aids such as absorbent pads: when you use them and how often you change them.
- Tell your doctor or healthcare professional if you have skin irritations in the pelvic area.
- Tell your doctor or healthcare professional if you have blood in your urine or pain in your abdomen, pelvic area or your back.
Talking frankly to your healthcare adviser is the first step towards identifying the problem and finding a solution.
Keep a diary
Keeping a diary of your toilet habits for up to a week before going to the doctor will be extremely useful.
Keep a record of what time you go to the toilet, both during the day and at night; how much fluid you drink, what type, and when; and how much urine you pass (use a measuring cup).
Also write down if you leak, how much and what you were doing at the time.
If you have pain, try and describe how it feels, where it is, when it happens and how long it lasts.
Links to bladder and voiding diaries
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UK and USA websites
- US National Institutes of Health: Daily bladder diary
- US Interstitial Cystitis Network: How to do a voiding & pain diary
What's wrong with me, doctor?
All this information will help both you and your doctor assess what you've got and to what degree. Talking frankly to your doctor or healthcare professional is the first step towards identifying the problem and finding a solution.