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, allowing your doctor to decide on a course of action or treatment plan.

Urodynamics procedures are routine and are nothing to worry about. Read on to learn more about your urodynamic test, the urine flow test, and how to prepare.

What is a urodynamic test?

The process of a urodynamics procedure depends on what specific test you’re having. Most urodynamic tests take around 30 minutes to complete.

Different types of tests require measurements from different parts of the lower urinary tract, but usually a very thin tube (approximately the width of a strand of spaghetti) will be inserted into the bladder. Other 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. By imaging the bladder in this way, it is 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 are intended to evaluate 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, especially in your day to day life, then you can use one of our incontinence pads, available for both men and women.

After your urodynamic 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. You will then discuss the results and next steps in treating your urinary symptoms with your doctor.

Remember, talking about bladder issues is nothing to be scared of, your doctor is there to help and give advice to relieve your symptoms.

What are some examples of urodynamic tests?

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

Some of the tests that may be used in your diagnosis could include:

Cystometric testing – the simplest form of urodynamic testing, this measures pressures within the bladder, how much urine your bladder can hold and the flow of urine when you pee
Video urodynamic tests – measures pressures within the bladder and the flow of urine when you pee while, at the same time, using an x-ray to see whether the bladder maintains the correct shape during filling and emptying. This method is particularly useful to diagnose and better understand a patient’s stress urinary .
Uroflowmetry (also known as a pressure flow study) – measures the volume of urine passed and the speed with which it is released. This method is used to better understand issues with passing urine, such as might be caused by an enlarged .
Postvoid residual urine measurement – used to determine if any urine remains after you pee.
Leak point pressure measurement – used to determine at what point the tube that connects the bladder to the outside world, the urethra, opens. In most cases, the urethra will remain closed even if the bladder is full and high pressure is being exerted on the urethra.

Electromyography – measures electrical activity of the muscles which are important to normal urinary tract function, such as the . When this method is used in combination with some of the methods described above, it is possible to determine the cause of a condition such as stress urinary incontinence.

Male Urodynamic testing vs female: what are the differences?

The types of tests used can differ slightly for men and women, depending on the symptoms experienced and the assessment of the healthcare provider.

For Women

For women with stress incontinence, the process of testing may involve observing what happens when leakages normally occur. You may be asked to walk around, cough, or laugh 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.

For Men

When urodynamic testing men 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. By measuring how quickly the bladder can be emptied, it's also possible through urodynamic testing to detect the extent to which an enlarged prostate causes an obstruction to urine flow.

Urodynamic testing can also be used to indicate an overactive bladder in both men and women.,

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

Are urodynamic tests painful?

Urodynamics tests aren’t usually painful, but some people may feel a little discomfort or stinging when the nurse initially inserts the tube into the bladder. Anaesthetic gel is used during this process, so any discomfort typically passes after a few seconds. You may also feel slight discomfort or a strange sensation as your bladder is filled.

If the discomfort gets too much or you are concerned, 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. In this case 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 new 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. This can provide valuable information about how much you drink and urinate, allowing your doctor to assess potential patterns.

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

If you think you may be experiencing bladder problems such as incontinence, book an appointment with your GP to start the process of getting a diagnosis. In the meantime, you may want to practice Kegel exercises or use TENA incontinence pads to stay confident and feel secure throughout the day.