What to Expect: How is Urodynamics Testing Performed?
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men and women with urinary problems including frequent urination, difficulty emptying the bladder, urinary urgency and incontinence. Urodynamics studies are performed in our offices by appointment.
Urodynamics Testing: Quick In-Office Procedure
Depending on the presenting symptoms, different tests are done as part of the urodynamic study. These range from simple tests to complex measurements with sophisticated equipment. Typically the procedure takes about 30 minutes to perform. Most patients report pressure sensation in the bladder but no significant pain during the procedure.
You would need to undress from the waist down. A small urodynamics catheter will be gently inserted into your urethra and the bladder. Your bladder will be filled slowly with saline (water solution). You will be asked to tell the urodynamics technician when you feel your bladder to be full, when you feel the need to go and when you cannot hold any longer and have to pee.
You will be asked to cough when your bladder is full to check how your bladder reacts to stress such as a cough.
Your doctor or urodynamics technician may simply record, using a specialized monitor, the time taken to start the urine stream and measure the volume of urine expelled. The ability to stop urination mid-stream may be tested.
The post-void residual test measures the volume of urine that remains in the bladder after it has been completely emptied (post-void residual).
Uroflow studies measure the speed at which the bladder is emptied. Cystometry measures the pressure in the urinary bladder. The strength of the urinary sphincter can be measured. Electromyography is done to measure the electrical activity in the neck of the bladder. Cystography (video urodynamic study) is a real-time x-ray that allows the urologist to visualize the bladder and urethra while filling and voiding.
- Uroflowmetry: The test involves urinating into a funnel or special toilet. No anesthesia is needed.
- Post-Void Residual: The test involves a bladder ultrasound. No anesthesia is needed.
- Cystometry: The test involves the insertion of a catheter with a pressure-measuring device into the bladder. The bladder is then gradually filled and the volume and pressure are recorded. The test is done with local anesthesia.
- Leak Point Pressure Measurement: The test involves measuring the pressure at the point of leakage during cystometry. You may be asked to cough, exhale sharply, or shift positions during this test. It is performed with local anesthesia as part of cytometry.
- Pressure Flow Study: The test involves measuring bladder pressure and urine flow rate. It is performed with local anesthesia as part of cytometry.
- Electromyography: The test involves measuring electrical activity in the bladder muscles and sphincters with special probes (sensors or electrodes) that are placed near the urethra.
- Cystography (video urodynamics): The test involves obtaining a dynamic x-ray image of the bladder while it fills and empties. Local anesthesia is used to insert a catheter into the bladder. The bladder is filled with a contrast medium that makes the images clearer. The test is associated with a small amount of radiation exposure and is performed only rarely when other types of urodynamic testing do not answer the questions posed.
What is the Preparation for Urodynamics study?
You can eat and drink normally and take all your usual medications on the day of the test. There is usually no sedation given, and you should be able to drive yourself home after the test.
It is a good idea to arrive for the test with a fairly full bladder. If you have any signs of a UTI, such as fever, chills, burning with urination, or blood in the urine, inform your urologist – your test may need to be rescheduled. Bring a list of your medications and allergies.
Notify the technician or urologist if you think you could be pregnant – some urodynamic studies involve exposure to radiation which is not safe for an unborn baby. If you have an artificial heart valve or low immunity, make sure your doctor is aware of this – you will need antibiotic coverage prior to testing.