Continence Assessment
Assessing urinary incontinence
The assessment of urinary incontinence is based on a consideration of all the possible causes, checking in particular that there is no underlying undiagnosed medical condition. A holistic approach should be employed so that confounding conditions are identified and addressed. There are many assessment forms available to collect patient data in relation to bladder problems. Many organisations have developed their own unique assessment criteria.
Evidence-based bowel care pathways are most widely used in the United Kingdom for assessing patients with many specialist continence practitioners adapting these tools to local need. A thorough functional assessment is also important where mobility and cognitive ability is compromised.
Symptoms can provide good indications of underlying bladder problems but further examination and investigations may be required, especially for those patients with new or severe symptoms. Clear protocols and pathways for referral should be established.
NICE documents give some guidance on investigations required for women with urinary incontinence:-
- Urinalysis is an essential part of any bladder dysfunction assessment and a urine dipstick should always be undertaken in all women presenting with a urinary tract infection
- Bladder scanning
- Pelvic floor assessment
- Urodynamics