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My Doctor wants me to have a test called Urodynamics.
What does that mean?


"Uro" means urine or related to the urinary system. "Dynamics" means moving against pressure. Health professionals recommend patients have urodynamic testing so they can have a better understanding of how urine moves through your lower urinary system and how well the bladder is working.


The lower urinary system consists of the ureters, bladder, urethra and sphincter muscle. The bladder is a balloon-like organ with a muscular wall that expands and contracts (squeezes). Urine travels from the kidneys to the bladder through tubes called ureters. Urine is stored in the bladder until you decide to empty it. Emptying occurs by a contraction of the bladder muscle. This means that the bladder muscle "squeezes" to empty the urine.


The sphincter [SFINK-ter] muscle sits right below the bladder and is around the urethra [yer-WREATH-rah]. The bladder neck is a tube that connects your bladder to the urethra. The urethra opens to the outside of your body, where urine comes out. If you are not ready to empty your bladder, then the sphincter muscle tightens up, like a knot at the bottom of a water-filled balloon. When you decide that it is time to empty your bladder, the sphincter muscle relaxes (like untying the balloon) and urination starts.


Urination takes place only when muscles and nerves are working correctly. Messages are constantly being exchanged between the bladder and brain through a pathway of nerves in the spinal cord. Sometimes a head injury, stroke, or other diseases of the spine will cause problems with a nerve pathway. Then the bladder may not empty correctly. But your bladder may not empty correctly even if you do not have any of these problems. Persons sometimes have incontinence (leakage of urine) before and after having bladder, pelvic, or back surgeries. People may leak urine when they cough or sneeze, maybe they leak urine when they have the urge to go to the bathroom, and maybe they leak urine for no reason at all. That is why it is so important to have urodynamic testing, to show how well nerves and muscles are working and find a cause for your urine control or voiding problems. The urodynamic test takes about 1/2 hour. It will be done in the office. You can drink non-alcoholic, caffeine-free beverages or eat anything you want before the test, unless given other instructions by your health provider.


On the day you go to have the test done, make sure your bladder is comfortably full. Go to the bathroom as you normally would until about 2-3 hours before your appointment time. At that point do not urinate anymore and drink 3-4 (8-ounce) glasses of fluid. Any thing you prefer is fine but water is the best option. If you can't make it, RELAX it is not the end of the world. Go to the bathroom and bring a large jug of water with you in the car and drink on the way to the appointment.


You will be asked to empty your bladder into a special commode. This will record how well you urinate, and how strong your stream is. A small tube called a catheter will be inserted into your bladder. It is about the size of a regular piece of spaghetti. It may burn slightly or feel a little uncomfortable when it is in place, or it may not bother you at all. It will be used to fill your bladder with water and measure the change in bladder pressure as it fills and empties. A very small tube will be inserted into your vagina. You should not feel this at all. It will measure the pressure in your abdomen when you strain or cough. Two patches or tiny electrodes, similar to an EKG test, will be placed on each of your buttocks near your rectum. These will monitor any muscle movement and its ability to work properly when you wish to urinate. These may cause a little discomfort when coming off, like pulling off a Band-Aid. If you have prolapse (bulging in your vagina) it will be pushed back and held up in place during the testing. This too may be a slightly strange feeling, but it is important to do the testing with the bladder and vagina in a normal position.


As your bladder is filled with fluid through the catheter, you will be asked to describe how your bladder feels. You may be asked to strain or cough several times. When your bladder is full, you will empty it. The entire test will be recorded on a computer, and you may even be able to watch it on a screen as it is occurring. Everything should be explained to you by the health professional as the test is being performed.


The catheters will be removed when the test is over. You may have a little discomfort where the catheters were placed. It may burn slightly when you go to the bathroom; this should last only a few hours. A warm tub bath (with no bath additives) will help to ease any discomfort. Drinking an adequate amount of fluid-usually 4-6 (8-oz.) glasses-is important (especially water) within 24 hours after the test. This will help prevent a urinary tract infection. An oral antibiotic well be given to you after the test and you will take it as directed at home with food. You may continue your diet, medications, and activities as normal, unless given other instructions by your health professional. After 24 to 48 hours your should not have any discomfort from the test. If you have any burning with urination, the frequent need to go to the bathroom or the urgent feeling you need to get there quickly, please call the office (609-924-2230). You may need more antibiotics.


After the test, an appointment will be made with the doctor to explain her findings and discuss treatment options with you.


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