Institute of urology is fully equipped with advanced urodynamic technology. This test is useful in assessing pressures and its relationship with voiding, unstable bladder contractions and urethral muscle pressures. CMG is an important test for assessing incontinence of urine, assess neurotic bladder and define female urinary incontinence or to assess leakage of urine after surgical procedures. The urinary tract is the body’s drainage system for removing wastes and extra water and if not managed properly can lead to kidney failure and heart failure. We accept most insurances for this procedure and also accept “pay as you need” patients.

Urodynamic tests are used to diagnose patients who have urinary incontinence or other urinary symptoms like frequency, urge or nocturia. These tests are given to both men and women to measure the nerve and muscle function, pressure around and in the bladder, flow rates, and other factors. These tests determines how well the bladder, sphincters, and urethra are storing and releasing urine.

 

Most urodynamic tests focus on the bladder’s ability to hold urine and to empty steadily and completely. These tests can also show whether the bladder is having involuntary contractions causing urine leakage or frequency or urge. Tests may be done if symptoms suggest problems with the lower urinary tract. The objective of urodynamic testing is to aid in the selection of an appropriate treatment either medical, surgical or a combination.

Urodynamic tests include:

• Uroflometry
• Post-void residual measurement
• Cytometric test
• Leak point pressure measurement
• Pressure flow study
• Electromyography
• Video urodynamic tests

Uroflometry is the measurement of urine speed and volume. You need to come to office with a full bladder or take the test when you have a strong urge to urinate. You will then be asked to urinate into a funnel at a special urinal or commode. A computer will measure the amount of urine produced and the rate of urine flow. It creates a graph that shows changes in flow rate. The results of the test can tell a lot about your bladder power and blockages in the urine passage.

The post-void residual measurement test measures the amount of urine left in the bladder after emptying the bladder so called post-void residual (PVR). This can be measured with ultrasound or with catheter. A post-void residual of 100 milliliters or more is a sign that the bladder is not emptying completely.

A cytometric test monitors how the pressure builds up in the bladder as it fills up with urine. It also tests the amount of urine the bladder can hold, and at what point you feel the urge to urinate. A catheter is used to empty the bladder completely. Then a small catheter is placed in the bladder, this catheter has a pressure-measuring device called a manometer. This can measure bladder pressures on machine. The patient is asked how the bladder feels and indicates when they need to urinate. This test measures abnormal contractions or spasms of your detritus muscle (smooth muscle in wall of bladder) during filling caused by overactive bladder. The test does not hurt however you may feel a pinch as the catheter is inserted. Once inserted you should not feel any pain or discomfort.

Leak point pressure measurement measures pressure at the point of leakage during a cystometric test. While the bladder is being filled for the cystometric test, it may suddenly contract and squeeze some water out without warning. The manometer measures the pressure inside the bladder when this leakage occurs. For those who leak urine with coughing/laughing/sneezing you may be asked to cough and/or strain at various points during the filling phase. The purpose of this is to encourage you to leak urine while allowing the machine to measure the amount of pressure that needs to be exerted to cause the leak. Please do not be embarrassed if leakage occurs. That is the point of this part of the test and the room is set up to accommodate this. Your provider will use these pressure readings to help determine an appropriate treatment plan.

A pressure flow study measures the pressure of the bladder required to urinate. It also measured the flow rate a given pressure generates. After the cystometric test, the patient will be asked to empty their bladder while the catheter is still in place. The catheter is small enough that most people are able to urinate around the catheter. Then the manometer is used to measure the bladder, pressure, and flow rate. In men, pressure flow study helps identify bladder blockage related to prostate enlargement. Bladder blockage is less common in women, but can happen with a cystocele (weakened tissue between a woman’s bladder and vaginal wall) or after a surgical procedure for urinary incontinence. Some are not able to urinate due to blockage or a weak bladder muscle. The test will still provide a large amount of useful information about your condition and help develop your treatment plan.

If the healthcare provider thinks the urinary problem is related to nerve or muscle damage, the cystometric testing will include electromyography. An electromyography uses sensors to measure the electrical activity of the muscles and nerves in and around the bladder and the sphincters. During this test, small electrode patches are placed in the skin near the urethra and rectum. These electrode patches pick up electrical current that is created when the pelvic floor muscles contract. The patterns of the nerve impulses show whether the messages sent to the bladder and sphincters are coordinated correctly.

Video urodynamic tests combine cystometry, uroflowmetry, and cystography into a single test. The digital equipment can measure urine flow and pressure in the bladder and rectum by using x-rays or ultrasound. Pictures and videos are taken of the bladder during filling and emptying. Video urodynamic tests provide useful information about bladder and urethral function. The pictures and videos show the size and shape of the bladder to help understand the underlying problem.

After urodynamic tests are performed, a patient may have mild discomfort or soreness with urination for a few hours. You may also notice small amount of blood in your urine. Drinking 16 ounces of water every hour for two hours may help ease symptoms. Your health provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening. Your doctor may recommend over-the-counter pain medication or prescribe an antibiotic to prevent infection. If there are any symptoms of infection, chills, pain, or fever, call your healthcare provider immediately.

Test results for cystometry and uroflowmetry are available immediately or after few days after completing the test. Other test results such as electromyography and video urodynamic tests may take a few days to process. Your health care provider will talk with you about the results, waiting time, and possible treatment options.

• NCBI.gov. Urodynamic studies (tests) for the management of urinary incontinence in children and adults Accessed on 1/23/2015.