Urodynamic investigations
Information for patients from Urology and Urogynaecology
You have been referred for urodynamic investigations. Urodynamic investigations will help diagnose your bladder problem. It is important that you have these tests. The results will help your medical team make an accurate diagnosis.
This leaflet explains the following.
What causes bladder problems.
What urodynamic investigations you will have.
What may happen if you do not have these tests.
How to prepare for your appointment.
What happens before and after your test.
Who to contact with any questions.
We hope it will help to answer some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
Why have I been referred for these tests?
It is important to find out what is causing your bladder problem. Once we know the cause, we can treat it.
What causes bladder dysfunction? and, how is it treated?
The most common causes of bladder dysfunction are as follows.
Urodynamic stress incontinence (USI), which is best treated with physiotherapy or surgery.
Overactive bladder symptoms. These symptoms are treated most effectively with bladder retraining and / or medication. And botox, if medication and retraining fail.
Bladder outflow obstruction (BOO) can be treated with medication or surgery, depending on how bad your symptoms are.
The urodynamic investigations will tell us which condition is causing your bladder dysfunction. Once we know this, we can discuss your treatment options.
What urodynamic investigations will I have?
At your appointment you will have a flow test. This is a simple test, which:
measures your flow rate (the speed at which you pass urine)
measures the capacity of your bladder; and
once you have passed urine, whether you have left any behind.
During the test a very small sensor is passed into your bladder and your rectum. For female patients, this may also involve passing the sensor into the vagina.
Urodynamic tests aim to recreate your bladder symptoms. The sensor measures the pressures in your bladder:
while we fill your bladder with fluid
while you are full and have the urge to empty your bladder; and
while you are emptying your bladder (this is done in private).
If you have video urodynamics (VUDs) as well, we will take x-rays during your investigation.
Will the investigations hurt?
A local anaesthetic gel is used during the investigations. This means the procedure may be uncomfortable or embarrassing, but not painful.
It is important that you have these tests. The results will help your medical team make an accurate diagnosis.
What should I do before I come to the hospital?
If you are taking any of the medication listed below, please stop taking them 7 days before your urodynamic appointment.
Flavoxate (Urispas)
Imipramine (Tofranil)
Oxybutynin (Cystrin, Ditropan, Ditropan XL)
Propantheline (Pro-Banthine)
Propiverine (Detrunorm)
Solifenacin Succinate (Vesicare)
Tolterodine (Detrusitol, Detrusitol SR)
Trospium Chloride (Regurin)
Toviaz
Betmiga.
Continue to take the following “bladder” medications. These medications will not affect your test.
Alfuzosin (Xatral)
Doxazosin (Cardura)
Dutasteride (Avodart)
Finasteride (Proscar)
Tamsulosin (Flomaxtra).
We will not be able to perform the tests if you have a urinary tract infection or cystitis. Please bring a urine sample to your appointment in a clean container, so we can test it.
If possible, come to your appointment with a comfortable full bladder, so we can perform a flow test.
We will ask you to complete a bladder diary before the test.
How long will my appointment take?
The tests takes approximately 30 minutes to complete. Be prepared to be in the department for up to 1 hour.
The tests will be explained to you when you come to your appointment. Please use this time to ask any questions. Remember, you can withdraw your consent for treatment at any time.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of:
medical treatment
test, or
examination.
Consent is usually given when you sign the consent form before your treatment. We may ask you to give your consent verbally (spoken rather than written consent).
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. Please speak to staff if:
staff have not given you this information, or
they have but you still have questions.
You must be capable of giving consent. This means you understand the information given to you, and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page.
What will happen when I arrive at the hospital?
A nurse will test your urine sample. If they find you have a urine infection, they will cancel and rebook your test for another day.
When do I get the results of my tests?
Patients are usually told the results of their tests on the day. You may go home knowing what the next step is, for example what medication may help or whether surgery is an option.
However, you may need to see your consultant again to discuss the way forward. If so, the hospital will send you an appointment for this. You will be told if you need this appointment before you leave hospital.
How will I feel after my procedures?
When you try to urinate, you may feel a stinging or burning sensation with some discomfort.
You may see some blood in your urine.
Please make sure that you drink plenty of non-alcoholic drinks for 24 hours after your procedure.
If these symptoms continue for more than 48 hours, contact your GP for advice. Take a urine sample with you, so your GP can test it.
After your test you can go back to all your normal activities. This includes work, driving, and sport.
For females and those of childbearing age undergoing urodynamics
It is not standard practice to investigate urinary symptoms through urodynamics during pregnancy. Therefore, if you are aware you are pregnant, please tell the staff, as the investigation may need to be rescheduled. If there is uncertainty about pregnancy, you may need to take a pregnancy test.
If you have had any of the following we will continue with your treatment as planned.
A hysterectomy.
Surgical sterilisation.
A Mirena coil fitted for more than two months.
A Depo-Provera contraception injection, which is not overdue for replacement.
You have gone through the menopause (had no periods for one year). Or you are going through the menopause and are certain you could not be pregnant.
However, if you are having a heavy period we may not be able to do the test. If this happens, we may reschedule the test for another date.
What happens if I choose not to have these tests?
It is your decision whether to have these tests. However, if you don't have the tests it may affect your consultant's ability to recommend the most effective treatment for you. This is particularly important if surgery is being considered. If you have any concerns, please speak to your consultant or GP.
Is there an alternative to having urodynamic investigations?
No. There are currently no other tests that give the same information as urodynamic investigations.
Further information
If you have any questions or concerns, please contact one of the following.
Urology Co-ordinator (for urology patients)
Telephone: 01227 864383Waiting List Co-ordinator (for urogynaecology patients)
Telephone: 01233 616095 (Tuesday, Thursday, and Friday)
References
Ask 3 Questions
There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:
What are my choices?
What is good and bad about each choice?
How do I get support to help me make a decision that is right for me?
Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.
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Patient Voice Team
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We have used the term ‘female’ in this leaflet. When we use this term we also mean people with female reproductive organs who do not identify as female. East Kent Hospitals is committed to supporting people of all gender identities. Please tell your doctor how you would like them to address you, so we can be sure to get this right.