A urodynamics test is used to find out how your bladder, sphincter (the muscle around the neck of your bladder) and the urethra (the tube that carries urine out of the body) are working. A urodynamics test can help find out the cause for bladder problems such as incontinence, or difficulty in passing urine. The urodynamics test may include X-rays to help your consultant make a diagnosis.
What Is A Urodynamics Test?
Urodynamic tests help doctors assess the function of your bladder and urethra (bladder outflow tract). They are usually done to investigate urinary incontinence in women.
During the tests, your bladder is filled and then emptied while pressure readings are taken from the bladder and the abdomen (tummy). The idea is to replicate your symptoms, then examine them and determine their cause.
What Is The Purpose Of A Urodynamics Test?
The purpose of a urodynamics test is to find out:
- if your symptoms are due to involuntary contractions (squeezing) or over activity of your bladder muscles
- if you have the bladder capacity we would normally expect
- if your bladder pressure is normal during filling and emptying
A urodynamics test is usually performed as an out-patient procedure. The test results will help you and your consultant decide if you need to alter your current treatment, or if you need surgery.
Before you come to hospital you will be asked to keep a voiding diary for three days before you come for your appointment. A voiding diary is a record of how much you urinate. You will need to record what type of fluid you drink, when and how much, and the timing and volume of urine output. You may also be asked to give information about when you experience urgency or urinary leakage.
What Can A Urodynamics Test Help Diagnose?
Urodynamics tests are used to help diagnose
- Stress urinary incontinence
- Urge urinary incontinence
- Mixed incontinence (stress and urge urinary incontinence)
A urodynamics test may also be helpful in investigating other causes of incontinence. Urodynamic tests are particularly important if surgery is being considered for the problem, to make sure the correct operation is performed.
What Happens During A Urodynamics Test?
The urodynamics test is performed in a room in the X-ray department. You will be asked to lie down on a special table and two thin tubes (catheters) are then inserted into your bladder through your urethra. You may feel the sensation of needing to pass urine as the catheters are put in. Some consultants may use a local anaesthetic gel when inserting these catheters but this is not always needed.
One of the catheters going into your bladder is connected to a sterile water machine and the other is attached to a pressure monitor. The pressure monitor is a special machine that measures how much liquid your bladder can hold and the pressure inside your bladder.
A third catheter is placed in your vagina if you are female, or in your back passage (rectum) if you are male. This is also attached to the monitor and measures the pressure that the rest of your body is putting on your bladder.
Once the catheters are in place, your bladder is slowly filled with sterile water (which may also contain an X-ray contrast dye). Whilst this is happening, you will be asked to tell the consultant when you feel the need to urinate.
During the test you may be asked to cough, strain or squeeze to check how your bladder reacts under pressure. Your consultant may take X-rays during this stage.
Some water may leak out during the test and wet you, but try not to be embarrassed by this. Remember your consultant is trying to find the cause of your bladder problem. Any fluid that leaks out is not urine but the sterile water that has been pumped into your bladder.
You will then be asked to empty your bladder so that the catheters can measure the flow rate and pressure at which you urinate. At the end of the test, the catheters will be removed and you will have privacy to dress.
The test usually takes 30 to 40 minutes and it should not be painful, although it may be uncomfortable at times.
Some people find the prospect of having the test embarrassing, but understanding what will happen during the procedure may help you with this. The staff looking after you will be experienced in performing this test and will try to put you at your ease as much as possible.
After the urodynamic study your consultant will review the results and may discuss them with you after the test, or you may be asked to return for a follow-up appointment with your referring clinician when the results will be explained.
The test will hopefully give a better understanding of your bladder problem and your clinician will offer suitable advice and treatment.
Urodynamics are a commonly performed and generally safe procedure. For most people, the benefits of having a clear diagnosis are much greater than any disadvantages. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Ask your urologist to explain how any risks apply to you.
After the catheters are removed you may feel some mild discomfort especially when passing urine. This should settle after a few hours. You may have some blood in the urine. This should settle after a day or so. To reduce the risk of developing a urinary tract infection you will be given a short course of antibiotics.
Preparing For A Urodynamics Test
You may be asked to arrive for your test with a comfortably full bladder. If this is difficult, you may be asked to arrive a little early so that you can have a drink to fill your bladder.
What To Expect After A Urodynamics Test
After the tests some people may feel a slight stinging or burning sensation when passing urine. If you drink plenty of fluids these symptoms should settle fairly quickly. If discomfort lasts more than 24 hours, take a sample of your urine to your GP for testing as it may be a sign of infection.
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 as it could be a sign of infection.
After a urodynamics test there is a small possibility that you may develop a urinary tract infection. This is caused by putting catheters into your bladder during the test. To help reduce the likelihood of developing an infection after the test, you may be advised to.
- Drink extra fluids for 48 hours after the test. This will help to ‘flush’ the system through. Aim to drink about two and a half litres a day for 48 hours after the test (9-10 cups)
- Cut down on tea and coffee for 48 hours after the test. This reduces irritation of the bladder until it returns to normal.
- Aim to drink water, herbal and fruit teas as well as juices and squash.