A bladder stress test is a special test that tries to simulate the accidental release of urine release that sometimes can occur if a person sneezes, laughs, coughs hard or exercises. It is often done as part of a physical examination if the patient says they involuntary pass urine while sneezing, laughing, coughing, or exercising.
A bladder stress test can also be performed if the cause of any urinary incontinence remains unknown after a physical examination and urinalysis has not shown any reason for incontinence. As part of this test another test called a 'Bonney test' may also be done – the bladder stress test and the Bonney test are quite similar except that in a Bonney test the bladder neck is raised slightly with an instrument as pressure is applied on the bladder.
However, the Bonney test is not done as a routine test in general practice as it needs a skilled doctor to conduct it and any incorrect diagnosis can worsen the condition by the wrong treatment being prescribed.
How is a bladder stress test performed?
Before coming for this test, the patient keeps a diary for a few days, noting down what and how often liquids are drunk and how often and how much urine was passed and involuntarily leaked. The pattern of urine leakage can provide important clues to the type of incontinence present. In the test itself, the patient lies down and a thin tube (a catheter) is inserted into the bladder via the urethra – the tube that urine passes through from the bladder.
This can cause a little discomfort as the catheter is inserted, but this is mild and short-lived. You will not need a catheter if your bladder is already full, but if your bladder needs filling, about 200-250mls of fluid is put into the bladder through it. The catheter is then removed and you are asked to cough. The doctor looks for any fluid leakage and notes the time interval between the stress (coughing) and the fluid loss. The stress test may be repeated while you are standing up. If the release of fluid is not detected during the bladder stress test it may be repeated while you are standing.
Are there any problems after a bladder stress test?
Some people may feel a slight stinging or burning sensation when they pass urine afterwards but this usually settles by drinking plenty of fluids. However, if this discomfort lasts more than 24 hours, take a sample of your urine to your GP for testing because it may be a sign of infection. To help reduce the chances of developing an infection after the test, drink water, herbal and fruit teas, juices and squash and cut down on caffeinated drinks such as tea and coffee for 48 hours – this helps to reduce bladder irritation. Aim to drink about two and a half litres of fluids a day for the 48 hours after the test and when you go to the toilet to pass urine, try to make sure that your bladder is fully empty. You can do this by waiting for a couple of seconds after you have finished passing urine and then trying again.