If you have urinary symptoms, your doctor may order a urinalysis or a urine culture (or both) to check for a urinary tract infection. If you have noticed involuntary leakage of urine (urinary incontinence), you should alert your doctor to this symptom. Involuntary loss of urine is sometimes related to anatomic changes at the bladder neck. Urinary stress incontinence is the most common type of urinary incontinence, occurring in up to 20 percent of women. Stress incontinence is the inadvertent loss of urine that occurs when there is an increase in intraabdominal pressure, such as when you sneeze, cough, laugh, or exercise. It is more likely to happen when the bladder is full and happens more frequently and inconveniently when the normal mechanism of the bladder and urethra is impaired. Often stress incontinence is also associated with genitourinary prolapse, a relaxation and "dropping" of the pelvic or urinary organs (or both).
A cystometrogram is a study to evaluate urinary incontinence. During this test the pressure and volume relationships of the bladder are measured as the bladder is filled with fluid (generally sterile water) or gas (usually carbon dioxide). This test helps determine the cause of the urinary incontinence and indicates whether surgical correction could treat the problem. Surgical correction of urinary incontinence can often be done at the same time as the hysterectomy, simultaneously correcting the urinary stress incontinence and treating the problem for which the hysterectomy is being done.
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