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.
  • Pelvic pain: There can be many sources for pelvic pain, including problems with the gynecological, digestive and musculoskeletal systems. Urological causes include interstitial cystitis (painful bladder syndrome) and kidney stones.
  • Prolapsed bladder: A “fallen” bladder can be the result of childbirth, hormonal changes, obesity, or straining when lifting, moving bowels or coughing.
  • Urethral syndrome: The chronic pain of urethral syndrome has no known cause, although studies are underway to see if it is related to hormonal imbalances, allergic reaction to foods or bath products, injury or over-sensitivity after recovering from a urinary tract infection.
  • Voiding dysfunction: This disorder is generally related to dysfunction of the nerves and muscles of the pelvic floor.

Diagnoses  

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 and nervous systems, reproductive organs and urine samples. If further tests are required, they might include:

  • Anorectal manometry: Used to study the function of the anus and rectum, this test evaluates of the strength of the muscles that control bowel movements. 
  • Complex uroflowmetry: This procedure measures the amount of urine in the bladder and the rate at which the urine flows.
  • Cystometry: Also called a cystometrogram, this procedure is administered to measure pressure in the bladder. The test requires patients to perform certain maneuvers while their bladder is being filled gently with sterile water through a catheter.
  • 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 that the muscles relax and contract as they should. 
  • Post-void residual study: This determines how much urine remains in the bladder after urination.
  • Pressure-flow voiding study: This test determines the ability of the bladder and urethra to properly expel urine.
  • Transrectal and transanal 3D ultrasound: These ultrasounds show images of the low rectum, anal sphincters and pelvic floor in patients with a variety of anorectal disorders.
  • Urethral pressure profilometry: This procedure reveals the pressure in the urethra. The results can help doctors guide surgical treatment.
  • Video urodynamic testing: This allows doctors to visualize the size and shape of your urinary tract. It is commonly used when you have experienced urine leakage or blocked flow of urine.

Keeping a bladder diary 

Womenshealth.gov* recommends 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 for each waking hour:

  • 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)
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