Urodynamics: what is urodynamic testing and how does it differ for men and women?

The term ‘Urodynamics’  describes various tests performed on the bladder and other parts of the lower urinary tract to show what happens as urine is stored and voided. Urodynamics testing can help diagnose the cause of urinary issues, before deciding on a course of action or treatment plan.

Urodynamic testing makes it possible to monitor specific areas of the complicated urinary system, and help identify whether there is any issue within a certain part.

Urodynamics procedures are routine and are  nothing to worry about! Read on to learn more about what will happen during the urine flow test, and how to prepare in the days leading up to it.

What is urodynamic testing? The process

The process depends on what urodynamic procedure you’re having, with most taking around 30 minutes to complete. Different types of tests require measures from different parts of the lower urinary tract, but usually a fine tube (approximately the width of a strand of spaghetti) will be inserted into the bladder. Other leads or tubes might be required, but these are very thin and easy for the doctor to position.

What happens next depends on the type of urodynamic test, but in most cases the bladder will be filled with fluid, and you’ll be asked questions about how you’re feeling while measurements are taken. Once your bladder feels full, you will be asked to urinate with the tube still in, to show what’s happening to your bladder when you empty it.

Other tests may be performed at the same time. For example, the liquid used to fill the bladder may contain a chemical which appears dark when viewed on an X-ray and by imaging the bladder in this way, it will be possible for a doctor to see whether the bladder maintains the correct shape during filling and emptying. This can also aid in diagnosing bladder conditions.

There’s no need to be embarrassed if you leak at any point during the test. Urodynamics is intended to monitor what happens during normal bladder function, and it’s important to see how the bladder responds in order to diagnose any problems.

If you're concerned about any further little leaks, then you can use one of our incontinence pads, available for both men and women.

After your test is complete, the tubes will be removed and you will be able to use the toilet if you need to, before getting changed in private. Then you’ll discuss the results and the next steps in treating your urinary symptoms. Remember, talking about bladder issues is nothing to be scared of, your doctor is there to help and give advice to relieve your symptoms.

Male Urodynamic testing vs female: what are the differences?

There are many different types of urodynamic tests. The doctor will use one or more methods in order to investigate your symptoms.

For women with stress the process involves observing what happens at the times that leakages normally occur. You'll be asked to walk around, cough, laugh, etc. to encourage a leak - all while measuring the activity in parts of the lower urinary tract. Sometimes an X-ray is used to see if the base of the bladder remains fully closed (as it should) during storage, or if it stays slightly open. The function of the pelvic floor muscles is also monitored to understand whether these are starting to weaken.

When it comes to urodynamic testing in males with urinary symptoms associated with an enlarged prostate, the bladder will be filled with a known volume of fluid and then, after voiding, the doctor can see if any remains. In addition, by measuring how quickly the bladder can be emptied, it's possible through urodynamic testing to detect the extent to which an enlarged causes an obstruction to urine flow.

Finally, in both men and women who have symptoms that indicate an overactive bladder, urodynamic testing can be used to understand bladder health. 

Some clinicians will want to see what happens to the muscle that comprises most of the bladder wall (‘detrusor’) as the bladder fills with urine. They are looking for contractions of that muscle during bladder filling, known as ‘detrusor overactivity’. 

Are urodynamic tests painful?

Urodynamics isn’t usually a painful test, but some people may feel a little discomfort or stinging when the nurse inserts the tube into the bladder. Gel is used as an anaesthetic, so any discomfort typically passes after a few seconds. You may also feel slight discomfort as your bladder is filled.

If the discomfort gets too much, just let your doctor or nurse know so they can try to make you feel more at ease.

How to prepare for urodynamic testing

Before your urodynamics procedure, you will need to get your urine tested. If you have an infection, such as a urinary tract infection, it will not be possible to perform the test and get accurate results, so you will be given antibiotics and your urodynamic appointment will be rebooked for a later date. You will then need to have your urine re-tested by your GP around 5 days before the test date.

Your doctor may advise you to either stop taking certain medications that affect your bladder or ask you to fill out a bladder diary which can provide valuable information about how much your drink and urinate to help your doctor spot patterns.

On the day of your test, you should eat and drink as you would on any other day and arrive at your appointment with a comfortably full bladder ready for your urodynamic test.

If you think you may be experiencing bladder problems such as incontinence, book an appointment with your GP to investigate. In the meantime, you may want to practice kegel exercises or use TENA incontinence pads to give you back your confidence and help you feel secure every day.