Urodynamics Evaluation

Before we proceed towards discussing the details of urodynamics evaluation, let's first understand what urodynamics is. Urodynamics is that branch of biological studies which observes and investigates the functioning of the lower urinary tract - i.e., the bladder and urethra - in order to come to a conclusion regarding whether or not there is any abnormality in this region's primary function of collecting urine and letting it out of the body the way it should. The entire scope of urodynamics study comprises a set of medical tests that are prescribed by the medical specialist to diagnose the urinary system for urinary disorders. Let's, now, take a detailed tour of what urodynamics evaluation is all about and what are the steps and procedures involved while going about it.

What Is Urodynamics Evaluation

As mentioned above, urodynamics evaluation is a series of tests and procedures conducted to examine whether or not the bladder and the urethra are functioning properly. Urodynamics evaluation is conducted to ascertain abnormalities regarding the passing of urine, if a person is experiencing any of the following conditions:-

• Urinary incontinence
• Thin or weak urine stream
• Incomplete emptying of the bladder
• Persistent urinary tract infection
• Frequent urination
• Presence of a constant urge to urinate which may not be accompanied by any actual release of urine
• Painful sensation while passing urine
• Strong, unpredictably abrupt urges to urinate

The purpose of conducting a urodynamics evaluation is to ascertain the underlying reason behind these aforementioned symptoms. Most common causes can be a malfunction of the lower urinary tract, enlarged prostate glands (in males) and overactive bladder syndrome. Women who have been previously treated for incontinence may be advised by their physicians to undergo urodynamics evaluation, if they show signs of conservative treatment failure or if their condition requires surgical intervention.

Tests and Steps Involved

The tests and procedures involved in urodynamics evaluation may differ for different people, depending upon individual cases. However, on a general note, a typical urodynamics procedure involves the following steps:-

• Preparation before the test involves taking prescribed antibiotic medication and get a urine culture done to ascertain the presence or absence of Urinary Tract Infection (UTI).
• Thereafter, a process known as Uroflowmetry is performed to gauge the quantity of urine that is passed on each instance and the strength with which the stream is released. The average flow is measured by dividing the total volume of urine passed during the testing phase with the frequency of urination during the same time-frame. This step ascertains whether there is anything wrong with the functioning of the bladder muscles or if these are weak.
• To ascertain whether or not the bladder is getting completely emptied after urine is passed, a Post Void Residual Test is conducted. In this process, immediately after you have passed urine, a catheter is inserted into your bladder and any remaining urinary fluid that is drained out is measured.
• The bladder capacity for holding urine is measured by conducting Cystometry in which, after evacuating the bladder completely with the help of a catheter, saline water is filled in the bladder using a Cystometer (which is a smaller sized catheter with a pressure gauge tube attached to it). A third catheter is inserted inside the rectum to gauge the pressure that accumulates there as well. Based upon how long you can hold on before feeling an urge to urinate, the saline water volume and the pressure on the bladder is measured. You may be asked to perform activities which exert pressure on the bladder such as coughing, laughing, straining, etc.
• The leak point pressure is measured when the bladder, while undergoing cystometry, ejects out some of the saline water by suddenly contracting. This is the leak point and the cystometer gauges the pressure of ejection at this moment. The reading of this measurement helps the physician ascertain what exactly is wrong with the bladder function.
• The nerve impulses are measured next, to investigate whether there is anything wrong with the nerves that control bladder functions. This is done by performing an Electromyograph to measure the impulses of the muscle nerves around the bladder. Sensors are placed on the skin just above the urethra and rectum to record muscular activity in this region. The patterns of these nerve impulses are recorded and studied in order to come to a conclusion whether it is the bladder function regulating muscles or nerves that are playing naught with the urination mechanism.

Due to the various invasive procedures undergone during a urodynamics evaluation (such as insertion of catheters and cystometer), you may experience slight discomfort in your nethers for sometime after the tests are over. Drinking lots of water and holding a clean piece of cloth soaked in warm water over the urethral and rectal opening would soothe any irritation or discomfort in that region. Depending upon the magnitude of gravity, and level of complexity, the results of the tests can be got immediately, or after a couple of days. The doctor may prescribe antibiotics in case of urinary tract or bladder infections and more serious cases may call for more complex medical treatment procedures. Whatever the case, it is advisable to see a doctor as soon as you notice an irregularity in your urinating pattern. After all, the earlier you solicit medical help, the more chances you have of nipping the complications in the bud.