If your condition is not easily diagnosed by a physical exam and a discussion of your symptoms, or if previous treatments have not improved your symptoms of incontinence, your doctor may suggest urodynamic testing. Urodynamics is a group of tests typically prescribed by a urologists, gynecologist, or urogynecologist that allows them to look at how your lower urinary tract works. Your lower urinary tract includes the urethra (which is the tube that carries urine from your bladder to the outside) and the bladder (which stores urine). Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely. Urodynamic tests can also show whether the bladder is having involuntary contractions that cause urine leakage.
Types Of Testing
There are several different tests which may be used to evaluate symptoms of the lower urinary tract. Because of your particular symptoms and concerns, tests which you can expect to be performed at your appointment are as follows:
- Uroflowmetry: The patient voids into a special commode chair that measures the rate, volume and time and gives a pattern for review.
- Cystometrogram (CMG): A dual lumen catheter is placed in the patient’s bladder and a catheter is placed in the vagina or rectum, then sterile water is instilled in the bladder. During this time pressures are obtained, including vesical pressure, detrusor pressure and abdominal pressure. During filling, sensations of the bladder are noted.
- Voiding Pressure Study: Immediately after filling the patient’s bladder, he or she is given the opportunity to void, and the previous pressures are measured during voiding.
- Leak Point Pressure: This measures the amount of abdominal pressure that causes a patient to leak urine. During the filling phase, the patient is requested to cough to see if leaking occurs. This may be repeated several times.
- Sphincter Electromyogram (EMG): Electrodes are placed around the anus to record the electrical activity of this area. This test is performed simultaneously with CMG.
Following The Test
After the test, you may experience a little stinging in the urethra until the next time you urinate. In some patients, this may last a little longer. If there was any resistance to the passage of the catheters, you may also see some blood discoloration of your urine. If needed, you will receive an antibiotic after the test is completed if you are prone to infections. To help reduce the likelihood of developing an infection after the test, your hospital may advise you to:
- Drink extra fluids for 48 hours after the test. This will help you to ‘flush’ your system through. Aim to drink about two and a half litres a day for the 48 hours after the test (9-10 cups of fluid).
- Cut down on your tea and coffee intake for 48 hours after the test. This will reduce bladder irritation until your bladder returns to normal.
- When you go to the toilet to pass urine, take a bit longer to make sure that your bladder is fully empty.
Your test results may be available immediately following the completion of the test, or you may be asked to return to your doctor’s office in a few days to review your results. The report will include a summary of the study results, your doctor’s diagnosis of your problem, and suggestions for further evaluation and treatment. After reviewing the results, your doctor will talk with you about the study report and your treatment options.