(BLADDER PRESSURE AND SPHINCTER ELECTROMYOGRAPHIC MEASUREMENTS DURING VOIDING FOR INCONTINENCE AND OTHER VOIDING ISSUES)
DIAGNOSING URINARY INCONTINENCE: URODYNAMICS TESTING
WHAT IS URODYNAMICS TESTING?
Urodynamics refers to a series of diagnostic tests that evaluate the function of your bladder and urethra. These tests may be recommended if you have urinary incontinence (leakage of urine), recurrent bladder infections, a slow/weak urinary stream, incomplete bladder emptying, or frequent urination. Urodynamics testing provides valuable information to aid in the accurate diagnosis of your urinary problems.
The Urodynamics Lab Setup at Men’s Health Alaska features the latest testing technology from 2018 with wireless pressure monitoring and bluetooth enabled uroflow studies from a separate room.
HOW TO PREPARE FOR URODYNAMICS TESTING: DIRECTIONS FOR THE DAY OF
Empty your bowels before coming to the office ‐ use one Fleets enema the morning of your test.
Bring your completed questionnaire and bladder diary if you have not done so previously.
Unless otherwise directed by your doctor, you should take your normally scheduled medications.*
Bring an extra pair of socks and do NOT wear lotion on your legs.
Empty your bladder 1 ½ hours prior to your appointment time, then begin drinking water frequently until your appointment – you should arrive in the office with a comfortably FULL bladder
You may eat before your appointment.
The procedure will begin with you undressing from the waist down. We will review the bladder diary and questionnaires with you and then you will empty your bladder on a special chair. A small catheter is inserted into your bladder; and another catheter will be inserted into the rectum. Two patches (like EKG electrodes) will be placed next to your rectum. We will attach all of the catheters and electrodes to a small computer and start filling your bladder with sterile water. You will be asked about the sensations you are having while your bladder is filling. There are no right or wrong answers to these sensations. Do NOT be afraid to leak urine – we want to determine which specific muscles are not working by causing you to leak during this test.
We will explain everything to you as it happens. The only discomfort you may have will be a stinging sensation when the catheter is inserted in the bladder. This sensation will disappear after a few minutes.
The series of tests typically takes about one hour. You will be able to resume all previous activities, including driving, upon completion of the Urodynamics studies.
*If you take Enablex, Detrol, Ditropan, Sanctura, Vesicare, Oxytrol or their generic equivalent stop taking 2‐3 days before Urodynamics study, or call the office if you have questions or are unsure of medication.
URODYNAMICS TESTING: UROFLOWMETRY
This study measures your urinary flow rate. You should come to the test feeling as though you need to urinate. Try not to empty your bladder one hour before your test is scheduled. You will be asked to urinate into a special commode that allows a computer to measure your urine flow rate and voided volume.
URODYNAMICS TESTING: EMG
This study measures how well you can control your sphincter (outlet) muscles and helps determine if they are working in coordination with your bladder. “Sticky patches” (electrodes) will be placed near the rectum to record sphincter muscle activity.
URODYNAMICS TESTING: CYSTOMETROGRAM
This study measures your bladder capacity, evaluates how your bladder holds urine, and determines how well you can control your bladder muscle. One very small catheter will be placed in your bladder, and another will be placed in your rectum. These catheters will measure both the pressure inside your bladder, and the pressure your body exerts on your bladder.
You will be asked to report the sensations you feel as your bladder is filled (such as when you first feel the need to urinate and when that feeling intensifies). You will be asked to cough or bear down during the test to check for leakage of urine. Do NOT be afraid to leak urine – we want to determine which specific pelvic muscles are not working by causing you to leak during the test. At the end of the study, you will be asked to urinate again.
URODYNAMICS TESTING: PRESSURE FLOW STUDY
This study measures how well the bladder muscles, the sphincter, and the urethra work together. This test may be done sitting or standing. Your bladder will be filled until you feel that your bladder is completely full, then you will be asked to urinate. The computer will measure the strength of your bladder muscles and sphincter, as well as the urinary flow rate and voided volume.
URODYNAMICS TESTING: URETHRAL PRESSURE PROFILE
The Urodynamic catheter is placed in the urethra to calculate the urethral closure pressure and the bladder pressure simultaneously. The results will be documented by the computer and provide additional information for your diagnosis.
TREATMENT OPTIONS AFTER URODYNAMICS TESTING
BIOFEEDBACK & PELVIC FLOOR THERAPY
This non‐surgical form of therapy is used to retrain the pelvic floor and/or bladder muscles. Typically, pelvic floor therapy consists of weekly sessions for six weeks. The first session will last about one hour, but the remaining sessions will be shorter. Using biofeedback and electrical stimulation techniques, a therapist will evaluate your muscle strength and instruct you on how to properly isolate and exercise these pelvic floor muscles. A computer can be used to guide you and monitor your progress. You will be educated in these techniques so that you can continue the exercises at home.
MEDICATION
Some prescription medication options may be available. Your doctor will discuss the results of your testing and if there are any prescription options right for you.
SURGERY
Your doctor will discuss any surgical options that are appropriate for you, based on your study results.