The urinary system of our body consists of the kidneys, sphincter, ureters, bladder, and urethra. In tandem with other organs, these parts perform the vital function of filtering the blood and removing unnecessary fluids such as urine from the bloodstream. Sometimes the urinary system ceases to filter waste and expel it from the body besides the ability to maintain a balance of chemicals in the body, Urodynamic testing is advised to detect such problems with the lower urinary tract. The test identifies how well the bladder can hold and empty the urine and if the bladder is contracting itself when it is not supposed to, causing the urine to leak intermittently.
Urodynamic testing helps diagnose patients who have the following recurring symptoms:
- Urinary incontinence
- Frequent urination
- Pain during urinating
- An overactive bladder
- Difficulty in emptying the bladder completely
- Frequent urinary tract infections
Types Of Urodynamic Tests
Depending on the diagnosis, the doctor may recommend any of these urodynamic tests:
Uroflowmetry: Uroflowmetry is the measurement of the speed and volume of urine. A urine sample is collected in a container for scaling. A graph shows changes in the flow rate of urine. The healthcare provider can see when the flow rate is the highest. Results are abnormal if the urine flow is blocked, or bladder muscles are weak.
Postvoid Residual Measurement: This urodynamic test measures the amount of urine left in the bladder post-urination. Also called postvoid residual, it is measured using a catheter inserted via a thin flexible tube inserted into the urethra.
Cystometric Test: A cytometric test is one of the urodynamic tests that detect the amount of urine the bladder can hold and the level of pressure that may build up inside the bladder. A catheter is used to empty the bladder and another smaller one is placed in the bladder that has a pressure-measuring device called a manometer. An additional catheter is used in the rectum to record exact urine pressure. Besides it also measures when the urge to urinate occurs. Once the bladder is emptied, the water is filled again, and the person is asked to describe the bladder condition besides indicating when the need to urinate arises. When the urge to urinate happens, water volume as well as bladder pressure is recorded. A cytometric test can also identify involuntary bladder contractions.
Leak Point Pressure Measurement: This urodynamic test measures pressure at the point of urine leakage. While the bladder is being filled for the cytometric test, it may suddenly contract and squeeze some water out without warning. The manometer measures the pressure inside the bladder when there is a urinary leakage. The patient may also be asked to apply abdominal pressure by trying to exhale or coughing. These actions help the healthcare provider evaluate the sphincters.
Pressure Flow Study: A pressure flow study is an effective urodynamics test that measures the bladder pressure required to urinate. The study helps identify bladder outlet blockage that some men may experience due to problems of prostate enlargement. Bladder outlet blockage is less common in women but can occur when the wall between the bladder and the vagina has become weak.
When Urodynamics Evaluation Should Not Be Done?
In the advent of the following situation, a urodynamics test should not be conducted
- If the patient is pregnant, urodynamics testing must be postponed
- If the patient has symptoms of burning or stinging with urination the day before the test, it should not be taken at that time
- If the patient has chronic constipation, some medication may be required until it is treated, and the body is prepared for the test
The results of urodynamic testing can take about 7 to 9 days. After the test, the person may feel mild discomfort and difficulty in urinating. It is advised to drink water every two to three hours which may help to reduce the discomfort. A warm water bath may also help relieve any kind of discomfort that the test may bring. Before the test, one should take a normal meal the day but there should be no caffeine intake. Enough water should be consumed so that there is a full bladder.
Risks Of Urodynamic Testing
Urodynamics testing just like any test may carry a small risk of developing a urinary tract infection or urinary frequency. Sometimes a small amount of blood may also show up along with the urine. Should any of these symptoms continue for more than twenty-four hours after the testing is done, the health care provider needs to be informed immediately.