Before you come to the 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. 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. 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.
A 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.
Any slight discomfort you may feel during the test should go away within a few minutes. Prior to filling your bladder with water, the nurse will give you instructions on sensations and feelings that need to be noted during the procedure. As your bladder is being filled with fluid through the tube catheter , you will tell the nurse what your bladder feels like.
When your bladder is full, several other tests will be performed to aid your doctor in diagnosing and treating your condition s. You may be asked to cough or bear down to mimic the symptoms you are experiencing. The nurse will monitor your bladder function, urethral function, and muscle activity during the test.
After the test, you will be asked to empty your bladder. Everything will be explained to you as the test is being performed. The catheters will be taken out when the test is over.
You may experience minor discomfort where the catheters were placed, but this will only last for a few hours. A warm tub bath may help ease discomfort. For the first part of the test, you will need to empty your bladder into a special toilet called a flowmeter.
This measures how much urine you pass and the flow of the urine. You will usually be left alone in the room whilst you are doing this. This is why you need to come to the test with a full bladder. Once you have been to the toilet you will usually have an ultrasound test performed to see how empty your bladder is.
This test is done by having some gel on the skin over your bladder and then an ultrasound probe being moved over this area. The next part of the test measures the way your bladder works as it fills up. You will be asked to lie down on a special bed. Two very thin tubes catheters are put into your bladder, by inserting them into the tube from your bladder that passes out urine your urethra.
You may find this a little uncomfortable. One is to fill up your bladder and the other is to measure the pressure in your bladder. Another catheter is put into your vagina or back passage rectum. This allows the pressure inside your bladder to be compared with the pressure outside your bladder. Once the catheters are in the correct position, fluid runs into your bladder at a controlled rate. This slowly fills your bladder whilst recordings are made.
The clinician performing the test will ask you questions - for example, how your bladder feels and when it feels full. Once your bladder is full, the bed will move and stand you upright. You may be asked to cough and some X-rays of your bladder are taken.
If you leak urine when you cough, try not to feel embarrassed. If you leak at home when you cough, it is best for the test operator to see you leak during the test.
It is important to remember that it is helpful to see how your bladder behaves on a day-to-day basis to make sure that the correct treatment is provided. You will then be asked to empty your bladder into the special toilet again at the end of the test, with the catheters still in place. If you are taking any medication for your bladder then it is likely that you will be asked to stop this for a week before this test.
Your hospital may ask you to arrive for your test with a comfortably full bladder. If this is difficult, some hospitals may ask you to arrive a little early so that you can have a drink to fill your bladder.
After the tests some people feel a slight stinging or burning sensation when they pass urine. If you drink plenty of fluids these symptoms should quickly settle. If discomfort lasts more than 24 hours, you should take a sample of your urine to your GP for testing because 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 also see your GP because it may be a sign of infection.
After having urodynamic tests there is a small possibility that you may develop a urinary tract infection. This is caused by putting the very thin tubes catheters into your bladder during the test. To help reduce the likelihood of developing an infection after the test, your hospital may advise you to:.
Some urodynamic tests involve using X-rays.
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