What is urodynamics?

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

Urodynamic tests are used for two reasons: firstly, unlike symptoms, what’s observed is less subjective or influenced by diet (caffeine, etc.); secondly, they make it possible to monitor just part of the complicated urinary system, and help identify if only a certain part of the system has an issue.

Having a urodynamics test is nothing to worry about! Read on to learn more about what will happen during the test, and how to prepare in the days leading up to it.

What happens during a urodynamics test?

Depending on what test or tests you’re having, most only take around 30 minutes to complete. Different types of tests require measures from different parts of the lower urinary tract but usually a fine tube 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 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, which shows what’s happening to your bladder when you empty it.

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 it responds in order to diagnose any problems and help your symptoms.

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 chat about the results and discuss any further steps.

Are urodynamics different for men and women?

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

In women reporting some leakage, urodynamics is used to see what happens with a relatively full bladder. You’ll be asked to walk around, cough, laugh, etc. to try to get you to leak - all while measuring the activity of 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.

In men reporting a feeling of incomplete emptying, 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 to detect obstruction caused by an enlarged prostate.

Finally, in both men and women that have symptoms perhaps due to overactive bladder, 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, which is called ‘bladder filling’.

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 uncomfortable 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 a urodynamics test

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

In the days leading up to your appointment, it may sound simple but do follow the instructions given to you! Your doctor may advise you to 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 you 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 all ready for your urodynamics 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.