Diagnosing type of bladder and/or bowel dysfunction

At the end of the assessment the assessor needs to analyse all the information and make a diagnosis about the type of dysfunction the person is experiencing.

Making the diagnosis is the most important part of the whole assessment process and is essential to ensure you develop an appropriate treatment plan with the person. If there is no diagnosis made you are in danger of offering ineffective treatment.

When making the diagnosis you need to consider the information you have collected from the different parts of your assessment, as a whole.

1. What type of bladder or bowel dysfunction most closely resembles your collected information

2. Are there patterns in what the person has told you and what you have observed that indicate specific conditions?

3. Does your diagnosis explain the person’s symptoms and condition?

Common conditions that you should be able to identify

Below are the common conditions you should be able to identify at the end of your assessment:

• Stress incontinence
• Overactive bladder
• Urgency urinary incontinence
• Mixed incontinence
• Incomplete bladder emptying
• Reflex incontinence
• Nocturia
• Nocturnal polyuria
• Nocturnal enuresis
• Functional incontinence
• Urinary tract infection (UTI)
• Unclear bladder diagnosis
• Constipation
• Anal incontinence
• Faecal incontinence
• Urgency faecal incontinence
• Passive faecal incontinence
• Faecal impaction with overflow incontinence

Clinical practice point. Some individuals will have a single diagnosis, for example, stress incontinence, but for many there will be several diagnoses to explain their condition, for example, an overactive bladder, stress incontinence and constipation. This will therefore need three treatment plans.

When discussion with a medical practitioner or referral may be required

There are also some symptoms where discussion with a medical practitioner is indicated, as further tests, or referral to a urologist, urogyneacologist, neurologist or colorectal surgeon may be required.

These include:

• Incomplete bladder emptying
• Reflex incontinence
• Nocturia and nocturnal polyuria
• Nocturnal enuresis
• Repeated urinary tract infections (UTIs)
• Unclear bladder diagnosis