Urodynamic testing is used to assess the function of your bladder and the urethra. During the tests, your bladder is filled and emptied with water through a catheter while pressure readings are taken from the bladder and abdomen. The goal of the testing is to try and mimic your symptoms, examine them and determined their cause so that a solution can be found. Your general practitioner or your gynecologist may order a urodynamics test.
Urodynamics testing is used to diagnose: stress urinary incontinence (leakage of urine with coughing or sneezing), urge incontinence (the sensation of having to use the bathroom) and mixed incontinence (stress and urge urinary incontinence).
Urodynamics is very important if surgery is considered in order to insure that the correct surgical procedure is chosen for patients’ symptoms.
Prior to the test discuss any medications that you are taking with your physician as there are some medications that should be stopped prior to having the tests performed. You will need to arrive to the test with a comfortably full bladder.
The tests include a:
1. Flow rate– the first step is for you to empty your bladder, using a special toilet that records the flow of your urine. A computer then charts any abnormalities in the flow rate.
- A decreased flow rate can indicate problems with bladder emptying such as an obstruction to bladder drainage or under activity of the bladder muscle.
- A fast flow rate is rarely a symptom of a medical problem. After you have emptied your bladder, a sample of urine is collected and tested to rule out an infection as the cause of your symptoms.
2. Filling cystometry: this test is used to replicate your incontinence symptoms, while seeing how your bladder pressure changes. One fine plastic tube (catheter) is inserted into the bladder. This tube records the pressure within the bladder and is used to fill your bladder with sterile water. The tube is inserted gently into your urethra (where urine comes out). A second fine tube (catheter) will also be inserted into either your vagina or rectum. This tube will measure pressure in your abdomen, which has an impact on your bladder. The two catheters that measure pressure in the bladder and abdomen are then attached to a machine that records changes in pressure. Sterile water is then put into your bladder slowly. This does not hurt but the fluid may feel cold. At the start of the filling you’ll be asked how your bladder feels. As your bladder fills, you’ll also be asked:
- when you first feel the need to pass urine
- if you can hold on past this point
- when the urge becomes stronger
Your bladder won’t be filled to the point where you are uncomfortable. Once your bladder is comfortably full, you will be asked to cough and perform some movements, initially while lying down and then when standing. Once the test is complete, you will use the special toilet again to empty your bladder. The tubes will be left in place this time, so bladder pressure can be assessed during emptying. After the test the doctor will interpret the results and explain them to you and recommend treatment, which may include surgery and or medicine. Complications of the procedure include discomfort passing urine.
After the tests some people feel slight stinging or burning when they pass urine. If you drink plenty of fluids (3-4 pints) for the first 24 hours these symptoms should resolve. If discomfort lasts beyond this time this may be a sign of a urinary tract infection and you should notify our doctor immediately. Some people also find a small amount of blood in their urine when they go to the toilet. This too should resolve within the first 24 hours after the procedure and if it does not resolve you should notify your doctor immediately.