Principles of the procedure
This procedure is performed to get a better understanding of your bladder symptoms and / or the underlying causes of your urinary incontinence / voiding difficulties.
The test involves placing small pressure and flow sensors into the bladder and rectum and assessing how your bladder functions with filling and emptying.
Procedure preparation and recovery
You do not need to be fasted for this procedure. It is performed either in the day surgery department of Varsity Lakes Day Hospital (video-urodynamics) or in Dr Tracey's rooms (urodynamics) by Dr Tracey and his Continence Nurse (Melissa). Following the procedure you will be able to drive home and continue with your normal daily activities as there is no sedation involved.
The Urodynamics Procedure
On presentation for the urodynamics procedure, you will be asked to change into a hospital gown. A bag / hanger will be provided to place your clothes and other belongings which accompany you into the procedure room.
You will initially be asked to do a void (empty your bladder) to initially measure the flow and bladder emptying. It is requested that you try to attend with a comfortably full bladder (though we do appreciate how difficult that can be) and not empty it immediately prior to the investigation.
Two small catheters (tubes) will be introduced into the urethra (into the bladder) and rectum / vagina. These are connected to a monitoring computer. The bladder is then filled with fluid and you will be asked to notify us when you feel changing sensations in the bladder as it fills. With video-urodynamics, x-ray contrast is given with the fluid and pictures are taken as the bladder fills. Generally there are 4 “check points” that we are looking out for:
Initial sensation (the feeling of fluid going into your bladder)
Initial voiding sensation (the first feeling of needing to go to the toilet - but not enough to warrant going straight away)
Strong voiding sensation (the feeling that you would be heading off to the toilet i.e. enough to get you off the couch at home or to be finding the bathroom if out and about)
Capacity (you absolutely could not hold any more in your bladder)
Generally this investigation is performed along the way of assessing problematic urinary incontinence. Sometimes dynamic procedures are carried out in that assessment (Valsalva - straining / bearing down, coughing). Do not be concerned if you do have an accident during the investigation - that is precisely what we are looking for so that a clear diagnosis can be made for you.
Following the filling study, you will be asked to empty your bladder into a commode with the small bladder catheter in place, to measure the flow and bladder pressures with voiding.
The whole process takes between 30-45 minutes, though this can be variable from patient to patient.
A formal report is then made for your referring urologist and your follow up will continue with your urologist.
Risks
There is a small risk of urinary tract infection (less than 1%). Your urine will be tested on arrival to minimise this risk.
Dysuria (burning) for 24 hours
Slight blood staining of the urine for 24 hours
Dr Christopher Tracey