urodynamics woman
Incontinence

Urodynamics: The Key to Figuring Out Your Bladder

When you hear the word urodynamics, what do you think of? When I first heard the word, I honestly thought of a car. It’s just something about the name that makes it seem mechanical, complicated, and intense. But, I can assure you that urodynamics has nothing to do with cars. Keep on reading to learn what urodynamics is and what it has to do with the bladder (because all things here lead back to the bladder).

What is Urodynamics?

Urodynamics is actually a group of tests that doctors use to check out how your lower urinary tract is functioning. However, not everyone gets all of the tests. Your physician will decide the types of urodynamic tests needed for you based on your individual health information, physical exam, and lower urinary tract symptoms, such as incontinence. The following are the different types of urodynamic tests:

The Types of Urodynamic Tests

Each of the tests mentioned above looks at something different, so here we’ll dive into what they assess.

Cystometry

A cystometric test is used to measure the pressure inside the bladder as pee fills it. The test also looks at how much pee the bladder can hold and how full it is when the urge to go begins. Most people feel pressure in the bladder when they have to use it, but it usually disappears once you go to the bathroom. If you experience this pain all the time, still feel it after you’ve peed, or don’t feel it all, this test is for you.

To do the test, your doctor will use a catheter to empty the bladder. After that, a smaller catheter with pressure monitoring is put inside the bladder to measure electrodes. One more catheter is placed in the vagina to look at abdominal pressure.

Once the bladder is empty, and catheters are placed, your doctor will slowly fill the bladder with warm sterile water. The doctor will ask you if you feel any bladder sensations and to let them know when you feel the urge to pee. They’ll also ask you to cough and strain to see if any drips and spritz happen. At the end of the test, your doctor will take a look at how pressure changes as pee leaves your bladder. If you do leak during the test, it might be a sign of stress incontinence. And if you’re looking for help with bladder leaks, Lily Bird has you covered with pads and underwear delivered straight to your door.

Electromyography

Doctors pull out the electromyography test when they think the issues you’re having are related to nerve or muscle damage. With this test, your doctor places a few small electrodes on either side of the rectum. They do this to record the electrical activity of muscles as certain impulses suggest potential problems with nerve signaling between your urethra and bladder.

Urethral Pressure Profile

Your doctor might recommend a urethral pressure profile if they think your sphincter is too weak or too strong. Usually, you’ll have this procedure following another type of urodynamic test, such as cystometry.

A medical provider will insert a bladder catheter and pull it along the length of the urethra to document urethral pressure and length. Urethral pressure is just the pressure inside the urethra applied by the urethral walls. Pressure is needed by the urethral walls, but too much prevents pee from coming out and too little might lead to unexpected drips.

The procedure will also help them calculate maximum urethral closure pressure. The maximum urethral closure pressure is the difference between the maximum urethral pressure and the pressure within the bladder (also known as intravesical pressure).

Uroflowmetry

Your doctor may suggest a uroflowmetry test if your doctor thinks your bladder muscles are weak or something is blocking proper urine flow. During the test, you’ll pee into a special toilet or funnel with a container for collecting the urine and a scale. The equipment will create a graph that shows changes in how fast urine comes out, AKA, the flow rate.

Voiding Pressure Study

For the voiding pressure study, also known as the pressure-flow study, a medical provider checks how the bladder functions as it empties. Once your bladder is completely full, you’ll need to pee in a unique commode chair. From there, your medical provider will review your bladder pressure and flow rate.

Postvoid Residual Volume

There are two ways to do the postvoid residual volume test. Here’s what you can expect for both scenarios:

Catheter Test:

For this procedure, you’ll pee right before the test. After that, a nurse will insert a catheter to drain out any pee that’s left behind. They’ll measure how much was taken out and determine if you have a UTI, issues with incontinence, or something else.

Ultrasound Test:

The ultrasound test is a more preferred option because it’s painless, and you don’t have to expose your private parts. Like the previous test, you’ll pee first. After that, a nurse will hold an ultrasound wand over your belly. If only the ultrasound wand could zap the incontinence away, right? Anyway, you’ll see pictures on a monitor, which your doctor will use to determine how much urine is left in there.

Videourodynamics

The last and final procedure is videourodynamics. It’s not a standard test mainly because the data you get from this test is obtainable from other tests. As a result, most people see it as an added expense and a majority of folks don’t like to spend unnecessary money. Nonetheless, this special x-ray can help your doctor better understand any abnormalities with the size and shape of your bladder and urinary tract.

During the procedure, a medical provider will fill the bladder with a contrast solution. As the bladder fills, your nurse will:

  • Ask when you first feel your bladder filling, how it feels during filling, and when you feel like you need to pee
  • Record different pressure measurements
  • Determine how much pee the bladder holds and,
  • Ask you to cough and push to check for bladder leaks

Reasons Why People Get Urodynamics

If you’ve been having some issues with bladder leaks, urodynamics tests will take a look at your bladder, sphincters, and urethra to see how they hold and release urine. These tests should reveal the cause of problems related to:

  • Bladder leaks
  • Frequent urinary tract infections
  • The need to go too often
  • The need to pee suddenly
  • Weak urine flow
  • Intermittent urine flow (the flow of urine stopping and starting)
  • Bladder not emptying all the way

Getting Answers: Urodynamic Tests

If you’re having any issues with leaks or having pain in your bladder, your doctors will likely recommend a urodynamic test. These tests help to put a name behind what we feel so we can get the proper help we need. There’s always a sense of relief you get when you at least know what’s going on with your bladder.

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By Jessica Thomas, MPH