Treatment / Female Incontinence - Diagnostic Procedures

URODYNAMICS

What does the test involve?

Urodynamic testing aims to show what happens to the bladder on filling and emptying. It helps to find out what the cause of your bladder problems, including empty and whether the flow of urine is even, or whether it stops and starts. Urodynamic testing also shows how well your bladder tightens at the start of the flow of urine and how much pressure is in your bladder and urethra. It is a test that can enable the doctor to diagnose the problem and assist them in formulating a treatment plan.

Are there any alternatives to Urodynamic testing?

This is the only definitive test that can be performed if there is no obvious cause of your bladder problems. Your doctor may suggest alternative tests such as an ultra sound scan of your bladder, obtaining a sample of urine to check for infection or a camera examination of the bladder depending on your individual symptoms.

How to prepare for Urodynamic testing

Prior to having the test, you will be asked to complete a bladder diary which involves you recording how much you drink and how much urine you pass and, a questionnaire relating to your symptoms. This will help your doctor understand your bladder problem.

If you are taking any medications to treat your bladder problem, you may be asked to stop these before the test. Your doctor or nurse will advise you which medicines to stop and when to stop them.

Urodynamic testing is usually done as an outpatient procedure and you may eat and drink as normal. It is also important that you are not constipated when attending for the test as this may affect the result.

Your doctor or nurse will ask you to attend for the Urodynamic test with a comfortably full bladder, if this is not possible it would be helpful if you could arrive early for the appointment and drink to fill up your bladder. As part of the test you will be asked to pass urine into a machine called a flow meter, which measures how much urine you pass and what the flow is like.

What happens during Urodynamic testing

Urodynamic testing can take up to 30 – 45 minutes. There will be a doctor and a nurse present for the duration of the test. You will be asked to remove clothing from the waist down and change into a gown. The doctor will discuss your symptoms once again prior to the test and ensure you are happy to go ahead.

You will be asked to complete the flow test, following this you will be asked to lie on a couch and scan will be performed to check if you are emptying your bladder. Once this is completed 2 fine tubes will be passed into the bladder and 1 fine tube will be passed into the rectum using anaesthetic gel, you may experience a little discomfort and stinging due to the gel but this will pass in seconds. These tubes will be connected to a computer system and a bag of sterile fluid which is used to fill the bladder at a controlled rate. This enables pressures both inside and outside the bladder to be measured.

While your bladder is filling, you will be asked to cough at certain intervals and report how you are feeling and when you get the sensation that you want to pass urine. Remember that this test is designed to mimic the symptoms you experience and recreate what happens to your bladder. You may have some leaking of urine, please do not worry or feel embarrassed.

When your bladder is full you will be asked to stand and cough to measure any leakage and then pass urine into the flow meter once again. The test is now completed and the nurse will remove all the tubes and you will be able to get dressed.

Advice following Urodynamic testing   

You are advised to drink plenty of fluids once you go home. There is a small possibility that you may develop a urinary tract infection which may be caused by inserting the catheter tubes for the procedure. If you develop any of the following symptoms we would advise you to see your GP:

• Blood in your urine
• Cloudy, offensive smelling urine
• Needing to pass urine urgently or more frequently than prior to the urodynamic test.
• Pain in the lower abdomen or back
• Burning sensation when passing urine
• Developing a fever or feeling unwell

Urodynamic testing is generally safe and commonly performed and the risk of developing a urinary tract infection are minimal, however in order to give informed consent for the procedure you must be made aware that this may be a potential side-effect.

Will I receive a follow-up appointment?

The doctor will discuss the results of the test with you following the procedure and a treatment plan will be discussed. Written confirmation detailing this plan will be sent to you.  A formal letter will also be forwarded to your GP. You will be able to go home when you are ready and return to your usual activities straight away.