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Incontinence Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Incontinence. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you had the problem of incontinence?

    Why: to determine if acute or chronic.

  2. Is there incontinence of urine, bowel or both?
  3. Is the bowel or urine incontinence intermittent or constant?

    Why: intermittent bowel incontinence may suggest epilepsy or delirium.

  4. If bowel incontinence, is the stool volume small or large?

    Why: a small volume would suggest an anal fissure, hemorrhoids, diarrhea, post-operative incontinence after a removal of a fistula or other surgery in the rectal area.

  5. If bowel incontinence, is the incontinence for solid, liquid or gaseous bowel contents?
  6. If bowel incontinence, are you aware of the bowel incontinence while it is occurring or only after the event?

    Why: if aware only after the event it suggests an associated sensory loss e.g. cauda equina lesion.

  7. If urinary incontinence, is the volume of urine large or small?

    Why: If the volume of urine released is small, stress incontinence and vesicovaginal fistula should be considered. If the volume of urine released is large should consider a neurological condition or an enlarged prostate with bladder neck obstruction.

  8. Past history of any anal surgery?

    Why: e.g. for fistula repair - anal surgery may not present with incontinence immediately after the surgery but may occur years after.

  9. Obstetric history?

    Why: especially history of a prolonged difficult vaginal delivery, unsatisfactory repair of episiotomy or third degree tear. May not present with incontinence immediately after but may occur years after.

  10. Sexual history?

    Why: to determine risk of syphilis and also to determine risk of sphincter trauma e.g. anal sex or sexual assault.

  11. Diarrhea, either acute or chronic?

    Why: may be cause of bowel incontinence.

  12. Rectal discharge of mucous?

    Why: may suggest anal ulcer, inflammatory bowel disease, rectal prolapse or hemorrhoids as the cause of bowel incontinence.

  13. Bloody stool or rectal bleeding?

    Why: may suggest rectal cancer, ulcerative colitis, hemorrhoids or anal fissure as the cause of bowel incontinence.

  14. Bowel Urgency?

    Why: may suggest diarrhea (most common), rectal cancer or proctitis (inflammation of the rectum) as the cause of bowel incontinence.

  15. Anal lump?

    Why: may indicate rectal prolapse or hemorrhoids as the cause of bowel incontinence.

  16. Pain with urination?

    Why: may suggest urinary tract infection as cause of urinary incontinence.

  17. Symptoms of stress urinary incontinence?

    Why: e.g. small amount of urine leaks when coughing, laughing, jumping.

  18. Symptoms of urge urinary incontinence?

    Why: e.g. need to pass urine frequently, often several times at night as well as during the day, urgency to make it to the toilet to urinate.

Conditions listing medical symptoms: Incontinence:

The following list of conditions have 'Incontinence' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Incontinence or choose View All.

View All A B C D E F G H I J K L M N O P Q R S T U V W

Conditions listing medical complications: Incontinence:

The following list of medical conditions have 'Incontinence' or similar listed as a medical complication in our database.

 

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