Urodynamics Clinic. Patient Information

Transcription

1 Patient Information Urodynamics Clinic Author: Gynaecology Produced and designed by the Communications Team Issue date May Review date May 2020 Version 3 Ref no. PILCOM1433

2 Urodynamics Clinic An appointment has been arranged for you at the Urodynamics Clinic, Basildon University Hospital. The Gynaecology Team would like to take this opportunity to welcome you to the clinic, and provide you with some information about your appointment. What is Urodynamics? Urodynamics is an investigation to assess the function of your lower urinary tract. Why do I need a Urodynamic assessment? The majority of women need a urodynamic investigation because of urinary incontinence - passing urine when you do not mean to. Other complaints include: zsudden urge to pass urine without warning (urge incontinence). zawakened several times at night by a sudden urge to pass urine (nocturia). zleaking urine when coughing, sneezing or laughing (stress incontinence). zno urge to urinate, bladder never empties, continuous leakage or small amounts of urine (overflow incontinence). It is also common for women to experience a number of these symptoms (mixed incontinence). Three to six million people in the UK are affected by incontinence. Women are twice as likely as men to have incontinence, although this figure is probably much higher, as many women do not report their symptoms. Living with incontinence can be very distressing and upsetting. Women report feeling unclean, embarrassed, have a loss of self confidence, feel that there is something wrong with them, are concerned that others can smell their urine odour and have often described how it has affected their work, home and social lives. What causes incontinence? There are various reasons why women are affected by incontinence. These include: zpregnancy and childbirth - which cause strain and pressure on the bladder and urinary tract, and can weaken the muscles in the pelvic floor leading to problems. z The menopause naturally decreases levels of the female hormone oestrogen, which has been found to have an effect on urinary incontinence. 2

3 zsome medications can affect the bladder s function. zsome women experience bladder control problems particularly when lifting heavy objects or when straining on the toilet to empty their bowels. How is incontinence treated? Following your Urodynamics investigation, your doctor will decide on the best treatment for you. The majority of incontinence complaints can be treated with physiotherapy, medication and, in some cases, surgically. Where is the Urodynamics Clinic? Please speak to reception when you arrive. Please come with a comfortably full bladder. Please let staff know if any of your personal details have changed, such as your surname, your address or the name of your GP, and if you have any disabilities or special needs. The investigation cannot be carried out during your period or if you have a bladder infection. Please tell us before your appointment if you have a latex allergy so that we can ensure latexfree equipment is available for your appointment. If you have any questions or concerns regarding your investigation, please telephone us before your appointment on extn Do I need to bring anything with me? You will need to bring a sample of urine with you, for us to test for any water infection. The nurse will test your sample at your appointment. If your sample detects signs of an infection, you appointment will be cancelled and rescheduled. A sample of your urine will be sent to the laboratory for further testing and your GP will be advised of the results in approximately 10 days. If you need antibiotic treatment, your GP will prescribe this. Once you have completed the course of antibiotics your GP or practice nurse will test your urine again to check the infection has cleared. Once the infection has cleared, you should telephone the Gynaecology Admissions Office to reschedule your appointment on extn Please bring your completed Voiding (passing urine) Diary over three days before your appointment. Use these charts to record how often you pass urine and how much you pass, day and night. You will need a 3

4 litre measuring jug to accurately measure how much urine you pass (1 litre equals 1000 millilitres/mls). Please also record the amount and type of fluid you drink on each day. It is important that you fill the charts in and bring them with you when you come for your appointment. This will help the nurse make a more detailed assessment of your problem. Many women find it more convenient to wear a loose fitting skirt rather than trousers to their appointment. If you use pads for incontinence, please bring these with you. Please continue to take any prescribed medication, but if you are taking any antimuscarinics or anti-cholinergies for an overactive bladder, you need to stop taking them seven days prior to this appointment. Here are some examples of this type of medication: zvesicare zoxybutynin (Ditropan, Lyrinexl) ztolterodine (Detrusitol) ztrospium Chloride (Regurin) If you have angina or asthma, please bring any sprays with you. If you take regular medication, please bring the name and dose with you. Please do not bring any valuables or large sums of money. 4 How long will my appointment take? Your appointment can take from 30 minutes to one hour to complete. Please allow time for parking and booking-in. You will be able to drive home alone after your appointment. Please do not bring children with you to your appointment as they cannot be with you during your procedure due to lack of space. There is a very small area for partners, but limited facilities are available to observe small children. You may eat and drink before and after your appointment. The procedure is always carried out by a female registered nurse with no other staff involved. However, our hospitals are involved in the teaching and education of student doctors and nurses. If you do not want anyone present during your appointment, please tell the nurse when you arrive. Occasionally there may be a visiting doctor, nurse or medical student in the unit and your permission will be needed for them to stay during your investigation. What happens during the procedure? The Urodynamics nurse will call you into the examination room. After testing your urine sample, the nurse will ask you about your medical history. They will then

5 explain the procedure to you and answer any questions you may have. You will be asked to empty your bladder into a computer-monitored commode. You will then be asked to lay on an examining couch. Your vulval area will be cleaned with sterile saline. Two catheters (small tubes) will be inserted, one into your vagina /rectum and the other into your urethra. Saline will be passed through the urethral catheter to fill your bladder. The computer will then monitor how your bladder behaves. Once you feel full, you will be asked to completely empty your bladder into the commode. The catheters are then removed and the test is complete. What happens after the procedure? You may feel discomfort when passing urine for about 24 hours following the procedure. Ensure you drink plenty of water. There are no side effects from the procedure. You can resume all normal activities afterwards, and you may return to work. The results of the test are sent to your Consultant who will review them and discuss them with you at your next outpatient appointment. 5 This appointment will be made after your investigation. What can I do to help myself? Whatever your symptoms, there are simple measures you can take to help: zavoid, or reduce, caffeine and fizzy drinks. These have been found to irritate the lining of the bladder. Replace with water, at least 1500mls (3 pints) daily to flush away any toxins and promote a healthy urinary tract. Do not avoid drinks through fear of leakage, as this will only make your problem worse and can lead to an increased risk of water infections and constipation. zif you are overweight, it may help to lose a few pounds. Larger women are at an increased risk of incontinence, as additional weight places more pressure on your bladder and urinary tract. zcutting down or quitting smoking is beneficial for your general health and will also reduce the risk of developing a chronic cough that places pressure on the bladder. z If you have a mild bladder weakness, avoid exercises that increase pelvic pressure on the bladder, such as running and

6 strenuous aerobic workouts. Try exercises such as cycling, pilates and swimming which will improve and tone the pelvic muscle. zstart pelvic floor exercises! It is never too late. Here is a simple guide but please talk to the nurse at your appointment. Pelvic floor exercises can be performed lying, sitting or standing up: Lift and squeeze your front and back passage muscles as if stopping yourself passing wind and passing water. Keep your buttocks relaxed. Hold for 10 seconds. Relax for 10 seconds. Then repeat. Repeat up to 10 times. Remember to completely relax the muscles before pulling up again. zyou should aim to perform three sets of exercises every day. In our busy lives many patients say they simply forget to perform pelvic floor exercises, so try to think about the things you regularly do each day to give yourself prompts. When you eat, waiting at traffic lights and at the beginning of a regularly watched television programme are some of the effective examples women have used. zonce every couple of months, try to perform the stop test. When passing urine in the toilet, perform one pelvic floor exercise and try to stop the flow of urine. Do not feel disheartened if you cannot completely cut off the flow of urine. This should improve in time. Most women feel the benefits within a few months. Who can I contact if I have any questions? If you have any queries about the date of your appointment, please call the Gynaecology Admissions Office on extn

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8 Not to be photocopied Basildon University Hospital Nethermayne Basildon, Essex SS16 5NL Minicom Patient Advice and Liaison Service (PALS) The Trust will not tolerate aggression, intimidation or violence. This is a smokefree Trust. Smoking is not allowed in any of our hospital buildings or grounds. This information can be provided in a different language or format (e.g. large print, Braille or audio version) on request