Causes and Diagnoses

Causes and Diagnoses of Female Urologic Conditions

Urologic conditions in women can have a variety of causes:

• Fistulas: A fistula can be the result of trauma or injury, surgery, infection or even radiation treatment. There are different types of urogenital fistulas, including vesicovaginal and ureterovaginal fistula.
• Prolapsed bladder: A “fallen” bladder or uterus can result from childbirth, hormonal changes, obesity, hysterectomy or pelvic surgery, or straining when lifting, moving bowels or coughing.
• Stress incontinence: Urine leakage with cough or strain can have similar causes as a prolapsed bladder.
• Voiding dysfunction: Dysfunction related to urination is generally related to dysfunction of the nerves and muscles of the pelvic floor.

Diagnosis of a Female Urologic Condition

If you are a woman with a urologic condition, it is important to consult your primary care physician for a complete physical examination of the urinary, nervous and reproductive systems. Your physician will also test a urine sample. Many conditions can be diagnosed through examination alone.

If further tests are required, they might include:

• Urodynamics: This test can identify the cause of leakage and measure how much your bladder holds. Patients will be required to perform certain maneuvers while their bladder is filled gently with sterile water through a catheter.
• Advanced video urodynamics: This study is only performed by urologists. It provides information from a urodynamics test (as listed above) and also includes visualization of the bladder and urethra using real-time fluoroscopy or X-ray. This can provide important anatomic information not viewable with a non-video urodynamics test.
• Cysto-urethroscopy: Also known as cystoscopy, this test is used to examine the inside of the bladder and urethra.
• Electromyography (EMG) testing: EMG testing determines if the nerves supporting the sphincter muscles are intact, and if the muscles relax and contract as they should.
• Post-void residual study: This determines how much urine remains in the bladder after urination.

Keeping a Bladder Diary

Consider keeping a bladder diary if you are experiencing loss of bladder control. Sharing this information with your urologist can help with the diagnosis and treatment of your condition. For a day or two, keep track of these occurrences every hour while you are awake:

• How much you drink
• What you drink
• How many times you urinate
• How much you urinate
• Urine leakage or strong urges to urinate
• What you were doing when you had a leak or a strong urge (such as physical activity, laughing or sitting)