A urodynamics study may be recommended by a Urologist if an individual has problems with storing or voiding urine. Urodynamics is a valuable tool for individuals diagnosed with urinary incontinence including frequent and urgent urination.
Essentially, urodynamics testing captures how well the bladder is functioning , while measuring its ability to retain and expel urine. Urodynamics testing is simple, virtually painless, and can be performed easily in an office setting.
Tests that may be done during urodynamics
Urodynamics consists of a series of individual tests. Each test gathers data that will be utilized in making a thorough diagnosis, and determining the appropriate treatment.
This test measures the amount of urine a patient voids from their bladder, and the speed in which it is expelled. During this test, the patient will urinate into a funnel that is attached to a computer. This computer records urine flow data over a designated period of time. The amount of urine left in the bladder, after voiding, is measured immediately after this test.
This test is done by feeding a catheter through the urethra into the bladder. Once in place, sterile water is poured into the bladder until it is full. The patient is then asked to report any sensations they feel, and whether these sensations are similar to symptoms they have felt at home. They may be asked to cough, stand, walk, or bear down during the test.
This test evaluates:
- How much the bladder can hold.
- How strong the bladder muscle is.
- How well the brain to bladder signals work that tell a person when their bladder is full.
This test helps evaluate the muscle contractions that control urination. Electrode patches, or wires, are placed near the rectum to make this recording. The patient will be asked to tighten and relax their sphincter muscles during this test.
Pressure flow study
This test measures the pressure and flow of urine out of the bladder. It is often performed after a cystometry. The patient is asked to urinate while a probe in the urethra measures pressure.
Urodynamics preparation
When scheduling patients for urodynamics testing, the provider will explain the specific instructions needed to prepare for this test. Urodynamics testing will take from one to two hours to complete. Patients will not be sedated, so a driver is not required.
In general, these instructions are recommended:
- Arrive at least 15 minutes prior to the appointment. Because this test is time intensive, late arrivals may need to be rescheduled.
- Do not empty the bladder when arriving at the office. Testing will begin with a full bladder, so be prepared to urinate during the test.
- Either wear or bring in a pair of clean socks.
- Before the urodynamics appointment, the patient will be asked to complete a bladder diary – generally three to seven days. This diary should be brought into the scheduled appointment.
- Do not apply lotion on the skin from the waist down.
- Clean and shave the pelvic area for catheterization, and the placement of adhesives. Discuss this with your provider for specific instructions.
- Patients with an InterStim device should bring their programmer.
On the day of the procedure, patients should call the office prior to their appointment if:
- They have a urinary tract infection.
- They have diarrhea.
- They have started their menstrual cycle.
- They have had cardiac exploration within the last six weeks.
Medications and dietary instructions
Patients are asked to stop taking anticholinergic medications three days prior to the procedure. These medications block certain neurotransmitters that would interfere with test results. These medications include:
- Amitriptyline
- Detrol
- Ditropan
- Sanctura
- Oxytrol
- Elmiron
- Flomax
- Uroxatral
- Urecholine
- Enablex
- Vesicare
- Toviaz
- Rapaflo
- Myrbetriq
Patients do not need to discontinue any routine medications or antibiotics. Talk to your provider to clarify which prescription medications should be halted before testing.
Dietary allowances for individuals without fecal incontinence
The day before the procedure, patients are allowed to have a regular breakfast and lunch. After lunch, patients should only consume clear liquids for the remainder of the day and evening. Milk and solid food is not permitted. Do not eat anything after midnight.
Clear liquids include:
- Water
- Fruit juice – no pulp
- Coffee – no cream
- Tea
- Soda
- Gelatin
- Popsicles
- Bouillon / broth
Fecal Incontinence preparation
Patient who have fecal incontinence, are asked to follow a special regimen before they arrive for their urodynamics testing.
The day prior to procedure
The patient should purchase two 10 ounce bottles of magnesium citrate. This product is sold at many pharmacies.
- At 1:00 PM – Drink one 10 ounce bottle of magnesium citrate followed by three 8 ounce glasses of any clear liquid. This should be done at home so that the patient is close to the toilet.
- At 6:00 PM – Drink one 10 ounce bottle of magnesium citrate followed by three 8 ounce glasses of any clear liquid. Again, stay close to the toilet after consumption.
It is important to drink all of the liquid with each dose of laxative in order to have an adequate bowel preparation.
After the procedure
It’s important for patients to know what to expect after their procedure. Patients may experience any of the following:
- Discomfort for a few hours after their test.
- Small amount of irritation when emptying their bladder. This may last for approximately 24 hours. If bladder irritation lasts longer than 24 hours, contact the physician’s office.
- Patient’s may pass a few drops of blood when they empty their bladder. If the patient passes blood clots, they should contact their provider.
It is recommended that patients drink eight to 10 ounces of fluid two days following their procedure. Water is ideal, and will help to prevent a urinary tract infection. Fluids will also help soothe any irritation. Finally, if the patient runs a fever of 100 degrees or more, they should contact their doctor’s office.
If you are experiencing urinary leakage, frequent urination or urgent urination, contact Urology Austin to schedule an appointment.