Many patients do not realize that leaking urine is a common symptom of two different problems. In urge incontinence, the patient will leak urine after a sudden urge to go to the bathroom, or may find that they do not have enough time to get to a restroom after the urge strikes. This is caused by spastic bladder contractions, and can be painful as well as embarrassing. In stress incontinence, patients often find that coughing, sneezing, laughing or lifting causes them to leak urine. This is caused by structural changes around the bladder, such as weakness of the muscles that support the bladder or of the muscle that closes it. Even though urge and stress incontinence both cause urine leakage, they have very different causes and require different treatments.

Cystometrics is a simple in-office procedure that helps determine if a patient has urge incontinence, stress incontinence, or a mixture of the two. The opening of the bladder is cleaned, and then a catheter is placed in the bladder. After the bladder is completely emptied, sterile water is allowed to flow in gently, and measurements are taken using the patient’s help to determine when they feel the need to go, when they feel completely full, and when the bladder is actually full. After this, the catheter is removed. A small swap similar to a Q-tip is placed to check the angle of the bladder, and the patient is asked to bear down to measure if the position of the bladder changes. After that, the swab is removed. From start to finish, cystometrics take ten to fifteen minutes. We interpret them in-office, and sometimes can start treatment of the incontinence that day.