Conditions and Treatments

Urodynamic evaluation for urinary symptoms and incontinence

Urodynamic Evaluation Studies are preformed by a CMUA physician with real-time instantaneous interpretation by a physician!

If you have a problem with urine leakage or blocked urine flow we may be able to help you. One of the tools they may use to evaluate the cause of your symptoms is urodynamic testing.

Several muscles, organs, and nerves are involved in collecting, storing, and releasing urine. The kidneys form urine by filtering wastes and extra water from the bloodstream. The ureters are tubes that carry urine from the kidneys to the bladder. Normally urine flows in one direction. If urine backs up toward the kidneys, infections and kidney damage can occur.

The bladder, a hollow muscular organ shaped like a balloon, sits in the pelvis and is held in place by ligaments attached to other organs and to the pelvic bones. The bladder stores urine until you are ready to empty it. It swells into a round shape when it is full and gets smaller as it empties. A healthy bladder can hold up to 16 ounces (2 cups) of urine comfortably. How frequently it fills depends on how much excess water your body is trying to get rid of.

The bladder opens into the urethra, the tube that allows urine to pass outside the body. Circular muscles called sphincters close tightly to keep urine from leaking. The involuntary leakage of urine is called incontinence.

 

Problems in the urinary system can be caused by aging, illness, or injury. The muscles in and around your bladder and urethra tend to become weaker with age. Weak bladder muscles may result in your not being able to empty your bladder completely, leaving you at a higher risk for urinary tract infections. Weak muscles of the sphincters and pelvis can lead to urinary incontinence because the sphincter muscles cannot remain tight enough to hold urine in the bladder, or the bladder does not have enough support from the pelvic muscles to stay in its proper position.

Urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests help your doctor see how well your bladder and sphincter muscles work and can help explain symptoms such as:

  • incontinence
  • frequent urination
  • sudden, strong urges to urinate
  • problems starting a urine stream
  • painful urination
  • problems emptying your bladder completely
  • recurrent urinary tract infections


Preparing for the Test

If the doctor recommends bladder testing, usually no special preparations are needed, but you will be asked to come with a full bladder

Taking the Test

Most urodynamic testing focuses on the bladder’s ability to store and empty urine. It can also show whether the bladder is having abnormal contractions that cause leakage.

Uroflowmetry (Measurement of Urine Speed and Volume)

A uroflowmeter automatically measures the amount of urine and the flow rate—that is, how fast the urine comes out. You may be asked to urinate privately into a toilet that contains a collection device and scale. This equipment creates a graph that shows changes in flow rate from second to second so the doctor can see the peak flow rate and how many seconds it took to get there. Results of this test will be abnormal if the bladder muscle is weak or urine flow is obstructed.

Measurement of Postvoid Residual

After you have finished, you may still have some urine, remaining in your bladder. To measure this, the doctor may use a catheter, a thin tube that can be gently glided into the urethra. He or she can also measure the postvoid residual with ultrasound equipment that uses harmless sound waves to create a picture of the bladder.

Cystometry (Measurement of Bladder Pressure)

A cystometrogram (CMG) measures how much your bladder can hold, how much pressure builds up inside your bladder as it stores urine, and how full it is when you feel the urge to urinate. The doctor will use a catheter to empty your bladder completely. Then a special, smaller catheter will be placed in the bladder. This catheter has a pressure-measuring device called a manometer. Another catheter may be placed in the rectum or vagina to record pressure there as well. Your bladder will be filled slowly with warm water. During this time you will be asked how your bladder feels and when you feel the need to urinate. The volume of water and the bladder pressure will be recorded. You may be asked to cough or strain during this procedure. Involuntary bladder contractions can be identified.