Urodynamic Testing Report

URODYNAMI
C TESTING
URODYNAMICS
 It is a study that assesses how the bladder
and urethra are performing their job of
storing and releasing urine.
URODYNAMIC TESTING
Urodynamic testing refers to the process of
performing urodynamics. Urodynamic tests help your
doctor see how well your bladder and sphincter
muscles work and can help explain symptoms such as:
• incontinence
• frequent urination
• sudden, strong urges to urinate
• problems starting a urine stream
• painful urination
• problems emptying your bladder completely
• recurrent urinary tract infections
PURPOSE OF URODYNAMIC TEST
• The tests are most often arranged for men with
enlarged prostate glands, and for women with
incontinence that has either failed conservative
treatment or requires surgery.
• The purpose of urodynamics is to provide
objective confirmation of the pathology that a
patient's symptoms would suggest.
• Urodynamics can be used to confirm the
presence of detrusor overactivity, which may
help guide treatment. An overactive detrusor can
be associated with urge incontinence.
PREPARING FOR THE TEST
If the doctor or nurse recommends bladder
testing, usually no special preparations are
needed, but make sure you understand any
instructions you do receive. Depending on the
test, you may be asked to come with a full
bladder or an empty one. Also, ask whether
you should change your diet or skip your
regular medicines and for how long.
For basic Urodynamic Testing:
• You will be instructed to arrive for testing with a full bladder.
• While you urinate into a container, the volume of urine and the
rate at which the bladder empties are measured.
• A thin, flexible tube (catheter) is then inserted into the bladder
through the urethra, and the volume of any urine remaining in the
bladder is measured (post-void residual, or PVR). A slight burning
sensation may occur when the catheter is inserted.
• The bladder may be filled with water through the catheter until you
have the first urge to urinate. The amount of water in the bladder is
measured at this point, and more water may be added while you
resist urinating until involuntary urination occurs.
 Any procedure designed to provide
information about a bladder problem can be
called a urodynamic test. The type of test you
take depends on your problem.
Urodynamic tests can range from simple
observation to precise measurement using
sophisticated instruments.
Uroflowmetry (Measurement of Urine
Speed and Volume)
 A uroflowmeter automatically measures the
amount of urine and the flow rate—that is,
how fast the urine comes out.
 This equipment creates a graph that shows
changes in flow rate from second to second so
the doctor or nurse can see the peak flow rate
and how many seconds it took to get there.
Results of this test will be abnormal if the
bladder muscle is weak or urine flow is
obstructed.
Measurement of Postvoid Residual
• After you have finished, you may still have some urine,
usually only an ounce or two, remaining in your
bladder. To measure this postvoid residual, the doctor
or nurse may use a catheter, a thin tube that can be
gently glided into the urethra. He or she can also
measure the postvoid residual with ultrasound
equipment that uses harmless sound waves to create a
picture of the bladder. A postvoid residual of more
than 200 mL, about half a pint, is a clear sign of a
problem. Even 100 mL, about half a cup, requires
further evaluation. However, the amount of postvoid
residual can be different each time you urinate.
Cystometry
(Measurement of Bladder Pressure)
• A cystometrogram (CMG) measures how
much your bladder can hold, how much
pressure builds up inside your bladder as it
stores urine, and how full it is when you feel
the urge to urinate.
• Involuntary bladder contractions can be
identified.
Measurement of Leak Point Pressure
• While your bladder is being filled for the CMG, it
may suddenly contract and squeeze some water
out without warning. The manometer will record
the pressure at the point when the leakage
occurred. This reading may provide information
about the kind of bladder problem you have.
You may also be asked to apply abdominal
pressure to the bladder by coughing, shifting
position, or trying to exhale while holding your
nose and mouth. These actions help the doctor
or nurse evaluate your sphincter muscles.
Pressure Flow Study
 After the CMG, you will be asked to empty your
bladder. The catheter can measure the bladder
pressures required to urinate and the flow rate a
given pressure generates. This pressure flow
study helps to identify bladder outlet
obstruction that men may experience with
prostate enlargement. Bladder outlet
obstruction is less common in women but can
occur with a fallen bladder or rarely after a
surgical procedure for urinary incontinence. Most
catheters can be used for both CMG and pressure
flow studies.
Electromyography
(Measurement of Nerve Impulses)
 This test measures the muscle activity in and

around the urethral sphincter by using special
sensors. The sensors are placed on the skin
near the urethra and rectum or they are
located on the urethral or rectal catheter.
Muscle activity is recorded on a machine. The
patterns of the impulses will show whether
the messages sent to the bladder and urethra
are coordinated correctly.
Video Urodynamics
 Urodynamic tests may be performed with or
without equipment to take pictures of the
bladder during filling and emptying. The
imaging equipment may use x rays or sound
waves. If x-ray equipment is used, the bladder
will be filled with a contrast medium that will
show up on the x ray instead of the warm
water. The pictures and videos show the size
and shape of the urinary tract and help your
doctor or nurse understand your problem.
AFTER THE TEST
 You may have mild discomfort for a few hours
after these tests when you urinate. Drinking an 8-
ounce glass of water each half-hour for 2 hours
should help. Ask your doctor whether you can
take a warm bath. If not, you may be able to hold
a warm, damp washcloth over the urethral
opening to relieve the discomfort.
 Your doctor may give you an antibiotic to take for
1 or 2 days to prevent an infection. If you have
signs of infection—including pain, chills, or fever
—call your doctor at once.
RESULTS
Normal
The amount of fluid left in the bladder after
urinating, when you feel the urge to urinate,
and when you can no longer hold back urine
are within normal ranges.
Abnormal
One or more of the following may be found:
 More than a normal amount of fluid remains
in the bladder after urinating. A large volume of
urine remaining in the bladder suggests the flow
of urine out of the bladder is partially blocked or
the bladder muscle is not contracting properly to
force all the urine out (overflow incontinence).
 The bladder contains less fluid or more fluid
than is considered normal when the first urge to
urinate is felt.
 You are unable to retain urine when the
bladder contains less than the normal amount of
fluid for most people.

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URODYNAMI

 This test measures the muscle activity in and

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