Introduction
Urodynamics is a series of tests performed used to get an accurate understanding of the function of the bladder. Urodynamics is often performed when initial treatments to manage urinary symptoms are not successful and in complex cases where the underlying cause of the patient’s symptoms is not immediately apparent. Urodynamics is also often performed prior to significant invasive procedures.
Preoperative Instructions
A urine test will be performed prior to the procedure to ensure there is no active urinary tract infection. An active infection will often require treatment prior to urodynamics. Urodynamic studies can be safely performed even when the patient is taking medications that increase the risk of bleeding such as warfarin, clopidogrel, apixaban and rivaroxaban. A number of other tests such as an ultrasound or CT scan and urine cytology may also be performed prior to a urodynamics.
Procedure
The procedure is performed with the patient awake under local anaesthetic. Initially the surgeon will ask the patient to urinate (in private) into a flow meter that measures the amount of urine passed and the speed at which it is passed. A catheter is then placed into the bladder to drain off the remaining urine and this amount is measured.
A cystoscopy is then performed with a flexible instrument to inspect the lower urinary tract.
Following this, a small catheter that fills the bladder and measures pressure is placed into the bladder and a similar catheter that measures pressure is placed in the rectum. The patient is then moved to the toilet and either sits or stands as they would usually do when urinating. The bladder is then filled with fluid and the pressure in the bladder is measured. X rays may be taken at different points whilst the bladder is being filled. The patient is then instructed to perform a number of tasks, i.e. coughing, straining, sitting to standing, to see how the bladder behaves during these tasks.
Once the patient feels the bladder is full, they are then instructed to urinate into the flow meter once more. During urinating, the pressures within the bladder are measured and occasionally X rays may be taken to identify possible problem areas in the flow of urine. Once the patient is finished urinating, the catheters are removed and the test is completed.
Postoperative Instructions
In the first 24-48 hours following urodynamics the patient may experience some burning and stinging whilst urinating. They may also notice some blood in the urine for up to a week. The patient is able go about their regular duties following urodynamics.
Risks
The risks of urodynamic studies include:
- Haematuria.
- Infection.
- Dysuria (burning / stinging whilst urinating).
Related Information
Incontinence
Benign prostatic hyperplasia (BPH)
Overactive bladder