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Urodynamics

Urodynamic testing or Urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests can help explain symptoms such as:

  • Incontinence
  • Frequent urination or inability to urinate
  • Painful urination
  • Urinary leakage
  • Recurrent urinary tract infections

Urodynamics are conducted in the office, and will provide your physician with the information necessary to diagnose the cause and nature of your urological problem.

Reasons for Urodynamic Testing

Urodynamics are most often arranged for men with enlarged prostate glands, and for women with incontinence that has either failed conservative treatment or requires surgery. Probably the most important group in whom these tests are performed are those with a neuropathy such as spinal injury.

Specific Tests

A typical urodynamic test takes about 30 minutes to perform. It involves the use of a small catheter used to fill the bladder and record measurements. What is done depends on what the presenting problem is, but some of the common tests conducted are;

  • Post-void residual volume: You begin with the insertion of a urinary catheter/transducer following complete bladder emptying. The urine volume is measured (this shows how efficiently the bladder empties).
  • The urine is often sent for microscopy and culture to check for infection.
  • Uroflowmetry: Free uroflowmetry measures how fast the patient can empty his/her bladder. Pressure uroflowmetry again measures the rate of voiding, but with simultaneous assessment of bladder and rectal pressures. It helps demonstrate the reasons for difficulty in voiding, for example bladder muscle weakness or obstruction of the bladder outflow.
  • Multichannel cystometry: measures the pressure in the rectum and in the bladder, using two pressure catheters, to deduce the presence of contractions of the bladder wall, during bladder filling, or during other provocative manoeuvres.
  • Urethral pressure profilometry: measures strength of sphincter contraction.
  • Electromyography (EMG) measurement of electrical activity in the bladder neck.
  • Fluoroscopy (moving video x-rays) of the bladder and bladder neck during voiding.