Urodynamics is a test to see how well your bladder functions. Some (but not all) reasons this test may be needed include for the evaluation of incontinence, for people with bladder emptying problems, to look for incontinence prior to surgery for pelvic prolapse, and for patients who have a poor response to medicines for incontinence. The purpose of this test tries to see how well your bladder empties, how well it holds fluid, if the bladder spasms, and how easy (if at all) leakage occurs with coughing and straining. Additionally, the test assesses how strong the urethra (outlet of bladder) is and if the bladder contracts and urethra relaxes during emptying. During the exam you will be sitting on a chair that is partially open on the base. Small catheters that measure pressure are connected to a computer that records everything that happens during the test. One catheter is placed through the urethra into the bladder to measure bladder pressure and to fill the bladder, and another is placed in the vagina or rectum to measure pressure in the pelvis. This urodynamics actually involves four separate tests listed below. Preparation- Please come to the appointment with your bladder comfortably full. If you take antibiotics daily to prevent urinary infections, continue to do so. If you take a medicine to calm your bladder down, please stop taking this 5-7 days prior to the test. Medicines that should be stopped include Ditropan, Detrol, Oxytrol, Vesicare, and Enablex. 1. Uroflow- This is the first test and involve emptying your bladder while on the exam chair.The purpose of this part is to see how your well you can void prior to placing any catheters. After this test your provider will pass a small catheter to completely empty your bladder before starting the other tests. Lidocaine gel is used on the catheter to minimize discomfort. 2. Cystometry- After placing the two pressure catheters (one in the bladder, the other in the vagina or rectum), the bladder is filled gradually to see how much it can hold. You will be asked to note when you have certain sensations during the filling. Also, at various time, you will be asked to strain (bear down, Valsalva) and cough to see if leakage occurs. 3. Urethral Pressure Profile- This is usually done with a full bladder and involves measuring the length and strength of your urethra (outlet of bladder). You will be required to do nothing while the catheter is slowly pulled out of your bladder and the computer records the strength of your urethra. 4. Pressure Voiding Study- This is the last test, and involves having you empty your bladder as best you can with all the catheters in place. Altogether, these tests take between 30-40 minutes to complete. The only discomfort from the tests is from the placement of the catheters, which are much smaller than urinary Foley catheters, such that some women do not even know they are there. The risk of the procedure is minimal: a 2-5% chance of bladder infection whether you are given antibiotics or not. The mild discomfort with voiding that may occur after the test usually resolves in 12-24 hours. If you feel like a bladder infection has developed after the test, please call our office at 303-837-7682 to obtain a prescription.
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