what is urodynamics?
Urodynamics is like a “stress test” for the bladder which helps the Urologist understand how well your bladder works. It is a simple diagnostic test which is painless, requires no sedation, and takes about an hour to complete. The urodynamic evaluation is tailored to answer specific questions about the function of the bladder, urethra, and muscles of the pelvic floor, as it examines the storage and emptying capabilities of the bladder. This important test provides necessary information needed to further diagnose difficult bladder and incontinence problems. Making the correct diagnosis is the first step towards devising an appropriate treatment plan.
A correct diagnosis can often be made by performing a physical examination, obtaining a medical history, and by thoroughly reviewing the patient’s voiding diary. If the etiology of the problem is still unclear, a formal urodynamic test may be needed.
What Can I Expect During the Exam?
The urodynamic evaluation is most often done in the medical clinic by a specialized technician. It is comprised of four main sections:
- Uroflowmetry – The patient is asked to urinate normally, while the strength of the urine flow is measured. The patient is instructed to void to completion (i.e., empty their bladder), and then the amount of urine left in the bladder after a normal void is measured (post-void residual urine).
- Electromyography – This portion of the test monitors the activity of the pelvic floor muscles during filling and urination (contraction, relaxation). Small electrodes in the form of patches are placed on either side of the anal opening, and remain there during the entire testing procedure.
- Cystometry – As the bladder is slowly filled with sterile water through a small catheter, this test measures bladder sensation, looks for abnormal bladder contractions, documents urinary leakage, and determines the filling capacity of the bladder (i.e., how much it can hold). It also examines how well the bladder transmits appropriate signals to the brain, to coordinate activity between the bladder and urethra/pelvic floor muscles during filling and emptying.
- Pressure/flow study – As the patient urinates, the bladder pressure required to initiate and maintain the flow of urine is measured. Tiny, pressure-sensitive catheters placed in both the bladder and rectum are used to measure this pressure.
Once complete, the physician will need to review the test before formulating an appropriate treatment plan. A follow-up appointment with your physician will be necessary in order to fully discuss the test results and proposed treatment plan.