What is urodynamic testing?
Physicians can use a set of tests to assist them in determining the cause of bladder or vaginal problems. Urodynamic testing studies bladder and urethral function in 3 different situations: when the bladder is empty, when it is filling, and when it is full. During testing of the patient's bladder, the physician strives to recreate the bladder conditions which caused the patient's symptoms. Ideally, these symptoms will recur during the test so that their cause can be identified. Specific urodynamic tests include measurement of the amount and rate of urine flow, measurement of the amount of urine present in the bladder following urination, and measurement of bladder capacity and bladder pressures. Each of these is explained below in more detail.
How is urodynamic testing performed?
For most women, urodynamic testing is not uncomfortable. Patients have control throughout the procedures and can request that testing be stopped.
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Uroflowmetry: Initially, patients are instructed to urinate into a special toilet that allows the physician to measure the amount of voided urine and its rate of flow.
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Measurement of Post-void Residual: Certain bladder problems can prevent the bladder from emptying completely. After the patient has urinated, the physician places a catheter in the bladder to drain and measure the amount of remaining urine. This retained urine is called the post-void residual.
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Cystometry: This test provides valuable information about the amount of urine that the bladder can hold, about the functioning of bladder muscles, and about nerve communication to and from the bladder. During this test, a special pressure catheter is used to measure pressures within the bladder. The tip of the catheter measures pressures when the bladder is empty, when the bladder is filled with sterile water by the physician, and when it is full. At the same time, a similar catheter may be inserted into the vagina to record pressures. Patients are often asked to cough or bear down during this test.
After testing, patients may experience some bladder discomfort with urination or a burning sensation at the urethra. Drinking plenty of water can help improve these symptoms. Patients are given two oral doses of an antibiotic to help prevent infection.
Why perform urodynamic testing?
There are various causes of incontinence and pelvic support problems. Physicians must know the exact cause of the problem so that effective treatment options can be offered. If surgery is planned, identifying the exact cause of the problem permits physicians to select a surgical procedure that offers the best chance of a long-term cure.
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