What is the test?
Urodynamics is a special test performed to assess your bladder function. It attempts to give a closer idea of how efficient your bladder is at holding urine and at passing urine. The test takes around 20 minutes in total.
Why am I having the test?
The urodynamics test has a range of different components and can provide information for a range of different bladder conditions. It may complement other tests being organised by your doctor to investigate your symptoms.
In particular the test is useful for people complaining of:
- Needing to go to the toilet frequently in the day or night
- A feeling or urgency / A compelling desire to rush to the toilet
- Urinary incontinence / involuntary loss of urine
- A poor stream of urine
- A feeling of incomplete bladder emptying
- Recurrent bladder infections
The test often provides useful information to identify the presence or cause of the above symptoms. It is also useful for women who are considering having surgery for prolapse as it may identify co-existent problems with your bladder that can be treated at the same time as your planned surgery.
The test aims to give a representation of your bladder’s behaviour in a relatively short twenty minute snapshot. For this reason, it is not always possible to mimic or reproduce your symptoms, or reveal a cause for your symptoms. In these cases, further investigations may be required.
What does the test involve?
At the beginning of the test, you will be asked to empty your bladder in a special commode. This part of the test gives information on the flow of your urine. Next , a small tube is placed into your bladder. This tube measures pressures in your bladder, and it also allows your bladder to be filled with fluid (either salt water or a special radio-opaque liquid that is visible on X-ray). One other fine tube (with a small inflatable plastic bubble) is passed just inside the back passage, which allows measurement of pressures inside the abdomen.
Over the next 5-10 minutes your bladder is filled, and the pressure changes inside your bladder and abdomen are registered by the urodynamic machine. This gives an idea of how your bladder functions as it fills. Once your bladder has been filled, the bladder is tested to see if there is any evidence of urinary leakage on straining the bladder (for example by coughing or jumping). You will then be asked to empty your bladder in the commode. After this, all the tubes will be removed.
If you are having a video-urodynamics test, the doctor will take a series of x-rays during the test to take a closer look at your bladder and urethra (the outlet pipe from the bladder ).
If you have significant prolapse, the doctor may insert a ring pessary or some bandage-like material into the vagina for a short duration whilst the bladder is being tested.
Is the test painful?
The test is well tolerated by most women. The insertion of the fine straw like tubes into the bladder may be uncomfortable for some women, but this sensation is extremely short-lived, and rarely reported as painful. The filling of the bladder with fluid is reported as a peculiar sensation by most women, but again is rarely reported as painful. Many women may get uncomfortable as their bladder gets full which serves as a marker for bladder capacity, and at this stage the bladder stops being filled.
How should I prepare for the test?
Let the doctor know if you have any signs of a urine infection. If you do, the test may have to be deferred as it may give rise to misleading results in the presence of an infection.
Let the doctor know if you think you might be pregnant
You have to pass urine at the beginning of the test, so it is useful if you arrive for the test with a relatively full bladder, without being uncomfortable.
What about after the test?
Most women will complain of a little lower abdominal discomfort after the test, like mild period pain. This will generally be very short-lived (a couple of hours), and rarely even requires simple painkillers (such as ibuprofen or paracetamol). Other women may notice a transient sensation of burning on passing urine the first couple of times after the test. It is sensible to ensure that you drink a good amount of fluid for a couple of days following the test to help with these symptoms. Very occasionally, you may develop a urine infection following the test (around one women in a hundred having the test). The symptoms are of a prolonged and persistent abdominal pain / pain on passing urine, and needing to go to the toilet very often for several hours. If so, you should consult with your GP, or phone the practice for some antibiotics. Sometimes the doctor will issue you with antibiotics at the time of your test.