Urodynamic testing

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Urinary bladder
Urodynamic trace of detrusor sphincter dyssynergia.

Urodynamic testing refers to the process of performing urodynamics. Urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests help your doctor see how well your bladder and sphincter muscles work and can help explain symptoms such as:

Urodynamic tests are usually performed in Urology, Gynecology, OB/GYN, Internal medicine, and Primary care offices. Urodynamics will provide the physician with the information necessary to diagnose the cause and nature of a patient's incontinence, thus giving the best treatment options available. Urodynamics is typically conducted by urologists, urogynecologists, or specialist urology nurses.

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Purpose of testing

The tests are most often arranged for men with enlarged prostate glands, and for women with incontinence that has either failed conservative treatment or requires surgery.

Symptoms reported by the patient are often an unreliable guide to the underlying dysfunction of the lower urinary tract. The purpose of urodynamics is to provide objective confirmation of the pathology that a patient's symptoms would suggest.

For example, a patient complaining of urinary urgency (or rushing to the toilet), with increased frequency of urination can have overactive bladder syndrome. The cause of this might be detrusor overactivity, in which the bladder muscle (the detrusor) contracts unexpectedly during bladder filling. Urodynamics can be used to confirm the presence of detrusor overactivity, which may help guide treatment. An overactive detrusor can be associated with urge incontinence.

Specific tests

These tests may be as simple as urinating behind a curtain while a doctor or nurse listens or more complicated, involving imaging equipment that films urination and pressure monitors that record the pressures of the bladder and urethra.

A typical urodynamic test takes about 30 minutes to perform. It involves the use of a small catheter used to fill the bladder and record measurements. What is done depends on what the presenting problem is, but some of the common tests conducted are;

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