When a patient presents with lower abdomen pain or problems related to passing urine, the healthcare provider usually orders a urodynamic test to determine if the source of pain is due to some dysfunction of the lower urinary tract, which is a collection of organ and muscles that performs the function of removing excess water from the human body.
So, what is urodynamic testing, and what does it entail. Before understanding urodynamic testing, lets look at the lower urinary tract and how it functions.
About Lower Urinary Tract
A human being’s lower urinary tract consists of the bladder as well as the urethra.
A balloon-shaped organ, the bladder stores the urine produced in the kidney. The urine is held with the help of pelvic muscles, which are present in the lower part of the abdomen.
The bladder remains relaxed when it is not full. Nerves signals the brain when the bladder approaches fullness. When the bladder is nearly full, one feels the urge to void or release urine.
The bladder muscles are signaled by the brain to contract or squeeze in order to force the urine out through the urethra.
Urethra comprises of muscles known as the sphincters. These sphincter muscles help in keeping the urethra closed to ensure there is no leakage before time. The contraction of the bladder results in the sphincter muscles to open and release urine.
Urodynamic Testing
Any procedure that looks at the functioning of the bladder, sphincters and the urethra is known as urodynamic testing. This test looks at how bladder, sphincters as well as urethra store and release urine.
Majority of these tests focus on the ability of the bladder to hold urine and empty it wholly and steadily.
Urodynamic tests help in diagnosing whether a person has urinary incontinence or any other urinary symptoms. Conducted on either gender, urodynamic test also helps in determining the presence of any involuntary contractions in the bladder, resulting in leakage.
A healthcare provider can recommend urodynamic tests if he/she believes the symptoms are related to a person’s lower urinary tract. Some of these symptoms include
- Frequent urination
- Urine leakage
- Painful urination
- A sudden strong urge to urinate
- Frequent urinary tract infections
- Problems with initiating a urine stream
- Problems with emptying the bladder
Types of Urodynamic Testing
Urodynamic testing involves the insertion of a small catheter into the bladder by a doctor, nurse or technician. Once the patient empties the bladder, it is refilled to take specific measurements. Around 30 minutes are required to complete different types of tests.
Some standard urodynamic tests include
Uroflowmetry
This test measures the urine speed as well as the volume.
Postvoid Residual Measurement
Amount of urine present in the bladder after voiding is known as post-void residual. This is measured through a test known as post-void residual measurement.
Pressure Flow Study
This is a test that measures the amount of pressure required by the bladder to urinate. The test also measures the flow rate which is generated at a given pressure.
Leak Point Pressure Measurement
The force generated by the bladder at the point of leakage is measured with the help of leak point pressure measurement.
Cytometric Test
A cytometric test monitors the buildup of bladder pressure as it fills up. The test also measures the amount of urine that can be held in the bladder, and at what point the patient gets the urge to urinate.
Video Urodynamic Tests
Video urodynamic test combines uroflowmetry, cystometry, and cystography in one single test. The urine flow is measured with the help of a digital equipment. X-rays or ultrasound are also used for measuring the pressure building up in the bladder as well as the rectum.
Electromyography
There might be a situation where the doctor might feel that the problem is a result of muscle or nerve damage. To understand the problem better, the provider might include electromyography during the cystometric testing.
Electromyography testing utilizes sensors for measuring the electrical activity of nerves and muscles present in as well as near the sphincters and bladder.
After the Urodynamic Testing
Once the urodynamic testing is completed, the patient might have mild soreness or discomfort for few hours while urinating. One might see the presence of blood (in small quantities) in the urine while the catheter is inserted.
These symptoms can be eased by consuming water (around 15 ounces) on an hourly basis for two to three hours. The doctor may also recommend the placement of a damp cloth on the urethral opening or taking a warm bath. A prescription for OTC pain medications or antibiotics is also provided for preventing infection.
In case, symptoms like pain, chills, infection or fever manifest and worsen progressively, the healthcare provider should be informed immediately.
Dr Prola is an experienced research biologist specialized in studies of cellular and molecular mechanisms by which energy metabolic pathways regulate disease development. He has keen interest in Urology and Renal function and his research on how Crocin protects human embryonic kidney cells was especially well received.
