How are bladder changes diagnosed?

Authors: SCIRE Community Team | Reviewer: Bonnie Nybo | Published: 18 January 2018 | Updated: 16 October 2024

Bladder changes are diagnosed primarily through a bladder examination. A bladder examination typically involves several components:

• Your health provider will ask you questions about your medical history, symptoms, bladder routine, and current treatments.
• You may be asked to complete a “urinary diary” and/or detailed questionnaires about your bladder care. This often involves recording how often you empty your bladder, how much urine is produced each time, and details about your fluid intake (what you drink, when and how much).
• A physical examination may involve an inspection of the abdominal, pelvic and genital areas, as well as neurological testing of your reflexes, muscle strength, and sensation.

Other testing may also be done if your health providers need further information.

The dipstick or urine test strip is a basic diagnostic tool for identifying presence of substances or infection in urine.³

A urine culture and sensitivity test involves collecting urine in a sterile container to test for infection. Urine samples are usually collected mid-stream while emptying so the test is more accurate. If the sample is collected from an indwelling catheter, the catheter should be changed first. Samples are never taken from a urine drainage bag.

Blood tests may be done if there is concern about kidney function, kidney damage, or an infection. This usually involves testing for blood urea nitrogen (BUN) and creatinine.

Ultrasound is an imaging technique that uses sound waves to visualize deep tissues. Ultrasound imaging may be done over the kidneys (known as renal ultrasound) to detect damage, kidney stones and infections.

Urodynamic testing includes special tests that can be used to look at bladder pressures and urine flow. It can test how the bladder acts when it fills and empties, how well it coordinates, and the pressure within the bladder. This test may involve urinating into a special container that can measure the flow and volume of urine, insertion of a catheter to measure the leftover urine, and inserting water into the bladder to measure your ability to prevent emptying. It may also involve placing a small catheter into the rectum that measures the electrical activity of muscles.

Bladder Capacity: The amount of urine the bladder can hold.

Voiding Efficiency: The amount of urine voided compared to the amount in the bladder before voiding. More efficiency means less urine is left in the bladder.

Bladder Compliance: The ability of the bladder to stretch in response to an increased amount of urine in the bladder. Without enough stretch there will be large increases in pressure, which is damaging to the urinary tract.

Other imaging, such as x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) are sometimes used for further investigation of bladder problems.

Cystoscopy (sometimes known as a “bladder scope”) is the use of a very small camera that can be inserted into the urethra to look at the urinary tract. Cystoscopy can be used to identify bladder stones, bladder health issues or damage including bladder cancer. It can also perform therapeutic procedures if needed such as removing tissue or stones.