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Urodynamic testing

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What is Urodynamic testing?

Urodynamic testing is the name given to a group of tests that are carried out to check the working of the lower urinary tract, mainly the functioning of the bladder, sphincters and the urethra. These are:

  • Uroflowmetry: This test measures the volume of urine released from the bladder per second, i.e., speed and volume.
  • Cystometry: Fluid is filled in the bladder with a catheter for assessing its muscle and nerve function. It assesses how much urine can be held by the bladder.
  • Urethral pressure profile: Evaluates pressure within the urethra using a probe.
  • Pressure-flow studies: Measures the rate of flow as well as the bladder’s pressure while urinating. This reveals blockage in bladder outlet.
  • Electromyographic studies: Assesses sphincter and pelvic floor muscle strength.
  • Video urodynamic studies: These are x-rays taken during cystometry and pressure-flow studies after injecting a dye.

Why is it conducted?

These tests are conducted to find out the cause of urinary incontinence and other problems related to urination.

Who should go for it?

  • Persons who experience leakage of urine during daily activities.
  • Persons who need to urinate frequently or have sudden uncontrollable urge to urinate.
  • People who find urination painful or difficulty in beginning to urinate.
  • People who are unable to empty the bladder fully.
  • Persons who get urinary infection repeatedly.

Procedure

It is not necessary that all the tests will be carried out. These are advised as per the patient’s symptoms. You will be asked to drink lots of water so that your bladder is full before the test can begin.

  • For uroflowmetry, you will be asked to urinate in a special container that will measure the speed as well as the amount of urine expelled.
  • Post void residual or urine left in the bladder is measured after inserting a catheter in the bladder.
  • Bladder pressure is measured with a cystometer, as part of cystometry,. Fluids are then filled in the bladder till the patient indicates an urge to urinate. The amount of fluid filled is noted. More fluid is filled till the patient reports an urgency to urinate. The patient may be asked to cough to check for leakage on strain. The fluid may be drained out if no further testing is to be done.
  • For pressure flow studies, more water is filled and the patient is asked to hold urination. Water is added till the patient is unable to hold and urination occurs with the catheter still in place. The pressure of the flow is measured with the catheter which has sensors attached to it. In some cases, sensors may also be placed in the rectum.
  • For urethral pressure profile, the pressure of the urethra walls is measured while taking out the catheter gradually.
  • Electromyographic studies are done only if muscle or nerve damage is suspected. Nerve activities are recorded with sensors placed around the urethra or the anus.
  • Video urodynamic studies are x-rays taken after contrast medium has been given. The rest of the procedure is the same as carried out in cystometry.

It is normal for there to be some discomfort for a couple of hours after the test is completed. Drinking a glass of water every half hour is advised. Some people may develop infection, though this is rare.

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Interpretation of results 

Results take into account the amount of urine left in the bladder after voiding, how much urine is contained in the bladder when the urge to urinate is felt and so on.

Written by: healthplus24.com team

Date last updated: February 03, 2015