What are urodynamics?
Urodynamics is the name given to a number of tests designed to show how your bladder functions. The main test is call cystometry, which measures your bladder’s ability to store urine. This is combined with an uroflow assessment, which records the pattern and rate of your urine flow.
Determining the cause of bladder problems involves discussion of your symptoms with your doctor, examination by your doctor and a variety of tests tailored to your particular situation. Urodynamics require interpretation, taking into account your reported problems, the physical examination and your medical history. They are the best way that your bladder function can be properly measured. Results from Urodynamic tests will allow Dr Onuma to get a better idea of what is behind your symptoms and, hence, advise you about the best options for treatment.
Urinary symptoms may include:
- Loss of urine during activities such as coughing, sneezing, laughing, exercise, intercourse, lifting and getting up from a sitting position.
- Needing to go to the toilet frequently during the day.
- Needing to get up at night to go to the toilet.
- Experiencing a sensation of urgency (the need to go to the toilet without delay) or suffering from urgency incontinence.
- Difficulty in starting to empty your bladder.
- Difficulty in emptying your bladder.
- Bladder pain or pain when emptying your bladder.
- Recurrent bladder infections.
Why are urodynamics done?
Urinary problems may affect women of any age. However, changes in bladder function away from the norm do increase with increasing age, pregnancy, childbirth and the onset of the menopause. There are numerous factors and conditions that may trigger the onset or worsening of urinary problems.
Other indications for Urodynamics
- Pelvic organ prolapse with urinary symptoms
- Pelvic organ prolapse without apparent urinary symptoms
- Anticipated major pelvic surgery
- Previous abnormal urinary function following anaesthesia
- Monitoring voiding dysfunction
- Followup after incontinence or prolapse surgery
How the test is performed
There are several slightly different ways that Urodynamics can be performed, but the principles are the same for all.
You will be asked to empty your bladder immediately before the test begins. A small probe will be placed just above your pubic bone to measure the amount of urine left in your bladder.
A small plastic tube (catheter) will be inserted into your bladder so that it can be filled with fluid (Saline). Two fine, soft catheters (sensors) will also be inserted, one into the bladder and the other into the vagina or rectum. These sensor catheters will record pressures measured in the bladder, urethra and vagina/rectum.
If your test involves an assessment of pelvic floor muscles then you will be asked to squeeze (contract) your pelvic floor muscles without lifting your buttocks or using your abdominal muscles. You will usually be asked to do this twice.
Finally, you will be asked to empty your bladder. In some cases, one or both fine sensors will remain in place as you do this. You will empty your bladder on a special commode in the same room as your study. Once you are sitting in position, the staff will leave the room so that you can empty your bladder in private.
Ring the bell when you have emptied your bladder. The catheter will be removed and you can get changed. If the catheters have already been removed then you can get changed immediately after ringing the bell.
Are there any risks?
- No matter how carefully the Urodynamics test is performed, urine infections can sometimes occur after it. Some people find a small amount of blood in their urine when they go to the toilet. If this lasts more than 24 hours, you should see your GP because it may be a sign of infection.
- To reduce the risk of infection you are advised to drink more water than usual for 1-2 days following the test to flush out any bacteria. In most cases, Dr Onuma will provide a single antibiotic for you to take immediately after the test. These strategies reduce the risk of having a urinary tract infection. If you think that you have a urinary tract infection, then please arrange to see your GP or Dr Onuma.
What to expect afterwards
- If you are a private patient of Dr Onuma, you will return to the consultation room to discuss the urodynamic findings and the options for your further management and treatment.
- If you have been referred by another specialist or by a public hospital then you will need to return to that specialist or the public hospital for your results and further discussions.
- A copy of the Urodynamics report is usually sent to your GP.