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Urodynamics is a simple out-patient investigation which helps us understand bladder function.  It involves inserting a tiny catheter into the bladder via the urethra and a second small catheter placed in the rectum (men) or vagina (women).  Through these it is possible to measure bladder pressures whilst the bladder is artificially filled via the bladder catheter and then when you pass water.

When you arrive for the investigation, you may be asked to pass urine into a device called a flow-rate machine. It is helpful therefore if you can arrive with your bladder comfortably full.  You will be asked to change into a gown and positioned comfortably on a couch and the two small catheters mentioned above will be inserted.  These tiny catheters cause only very minor discomfort.  During the test, your bladder will be filled slowly with water at a measured rate. You will be asked to cough and strain at intervals, and to tell us when you first feel the desire to pass urine. You will be encouraged to postpone voiding until your bladder feels quite full.

If one of your symptoms is leakage of urine, we will try to reproduce this so that we can see what the bladder is doing when the leakage occurs. Patients often find this embarrassing but it provides important information needed to treat your symptoms. We will do all we can to be as supportive as possible during this process.  When the bladder is full, you will be asked once more to pass urine into the flow rate machine. All the catheters will then be removed and you will be able to get dressed whilst the results are being analysed. Your Consultant will discuss your results and decide what action is needed to help your symptoms.

When you go home, we would like you to drink plenty of fluids for the first 24 to 48 hours to flush your system through.  The after effects of the test are minimal, but you may experience slight discomfort on passing urine, a slight blood stain in the urine.  There is a small risk of a urinary infection or rarely urinary retention.

Occasionally your consultant may decide that it would be helpful to screen the bladder in the X-ray department whilst the test is undertaken.  In this case the bladder is filled with water and a Xray contrast medium rather than just water.  This more detailed investigation known as video urodynamics can give additional important information for some more complex cases.

 

Dynamic Perineal Ultrasound:

In some cases of stress incontinence in women it can prove helpful to image the position of the pelvic floor under certain conditions such as straining and coughing. This investigation is carried non-invasively by one of our experienced female uro-radiologists using an ultrasound probe placed gently against the perineum.