What is Urodynamic Testing?

And How Advanced Gynecology Can Help

Urodynamic testing is a method doctors use to test for urinary incontinence — the involuntary leakage of urine in women. Urinary incontinence occurs when control over the urinary sphincter is lost or weakened. Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine.

We are always here to help you find the right care. Our patient coordinators can help you schedule an appointment for an exam or for urodynamic testing if your doctor has prescribed it as the next step in your treatment plan.

When You Should Get Urodynamic Testing

Urodynamic tests are used to show whether the bladder is having involuntary contractions that can cause urine leakage. You may want to consider having urodynamic testing administered if you are experiencing any of the following lower urinary tract symptoms:

• Urine leakage, frequent urination, or painful urination
• Sudden, strong urges to urinate
• Problems starting a urine stream or emptying the bladder completely
• Recurrent urinary tract infections

If you are experiencing any of these symptoms, it is recommended you meet with your doctor or specialist to discuss your current health circumstances to determine which method will be best for you.

Different Methods of Urodynamic Testing

Urodynamic tests range from simple observation to precise measurements using medical instruments. The doctor will decide which type of urodynamic testing is best for you based on your personal health information, a physical exam, and the lower urinary tract symptoms that appear. For simple observation procedures, the doctor may record:

• The length of time it takes to produce a urinary stream
• The volume of urine produced
• The ability or inability to stop the urine flow midstream

In precise measurement testing, imaging equipment takes pictures of the bladder filling and emptying, pressure monitors record the pressures inside the bladder, and sensors record muscle and nerve activity.

Different Types of Urodynamic Tests

The different types of urodynamic tests using special equipment include:

Uroflowmetry or Cytometric Test

• Uroflowmetry — Special equipment is used to automatically measure the amount of urine and the flow rate. Uroflowmetry measurements are conducted in a doctor's office and no anesthesia is needed.
• Cytometric test — This test measures how much urine the bladder can hold, how much pressure builds up inside the bladder as it stores urine, and how full it is when the urge to urinate begins. A catheter is used to empty the bladder completely, and then a smaller catheter that contains a manometer (a pressure-measuring device) is placed in the bladder. This test is performed with a local anesthesia.

Postvoid Residual or Leak Point Pressure Measurements

• Postvoid residual measurement — This test measures the amount of urine left in the bladder after urination using ultrasound equipment. The ultrasounds are performed in a doctor's office and anesthesia is not needed. The doctor may use a catheter to measure the postvoid residual, in which case they will use local anesthesia.
• Leak point pressure measurement — This test measures pressure at the point of leakage during a cytometric test. The bladder may suddenly contract and squeeze water out without warning during the cytometric test. The manometer measures the pressure inside the bladder when this occurs and provides information about the kind of bladder problem that exists.

Pressure Flow Study

A pressure flow study measures the bladder pressure required to urinate and the flow rate a given pressure generates. This study helps identify bladder outlet blockage. While bladder outlet blockage is less common in women, it can occur with a cystocele (a prolapsed or dropped bladder) or after a surgical procedure for urinary incontinence. This test is performed with local anesthesia.

Electromyography

This test uses special sensors to measure electrical activity of the muscles and nerves in and around the bladder and the sphincters. This test may be used if your doctor thinks the urinary problem is related to nerve or muscle damage. Sensors are placed on the skin near the urethra and rectum or on a urethral or rectal catheter, and the activity is recorded on a machine. Anesthesia is not needed if sensors are placed on the skin but will be used if sensors are placed on a urethral or rectal catheter.

Recovery After Urodynamic Testing

You may experience mild discomfort for a few hours when urinating after having urodynamic tests. Your doctor may recommend you drink an 8-ounce glass of water every half-hour for two hours to help reduce the discomfort. Your doctor may prescribe an antibiotic for one to two days to prevent infection. If you show any signs of infection including pain, chills, or fever, you should contact your doctor immediately.