Page 1 of 5 Undergoing a urodynamic investigation Introduction This leaflet is intended for the use of those patients undergoing urodynamics investigations. Definition Urodynamics is a diagnostic test, which studies the pressure within the bladder as it fills and empties urine. Urodynamics is performed for different types of bladder symptoms and is a common procedure performed before some types of urological or gynaecological surgery. The aim of the test is to: Reproduce the bladder symptoms that you are currently experiencing. Identify why your bladder may not be functioning normally. Ensure appropriate and individual treatment is planned. Risks Reference No. GHPI0622_01_13 Department Gloucestershire Continence Service Review due March 2016 Some patients may experience: Discomfort You may find it uncomfortable to pass urine for the first few hours after the test. It may sting when you go to the toilet. This is normal, and should go away within 24 hours. Drinking two to four extra glasses of water may help to improve this. Bleeding You may see blood in your urine after the test. This is a result of introducing the fine tube into your bladder. This is normal and should go away within 24 hours. Infection Despite the procedure being carried out in a sterile manner, introducing anything into the bladder carries the risk of infection. Signs of an infection include a temperature, feeling hot and cold or feverish; experiencing a burning sensation when passing urine (the urine may even be smelly) or generally feeling unwell. Some patients may also have to pass urine frequently or urgently.
Page 2 of 5 If more than two of these signs are experienced, please contact your GP for advice as soon as possible. Your doctor may require a urine sample to check for signs of infection before starting you on some antibiotics. Preparation prior to investigation If you are taking any medication for your bladder or prostate (for men), please stop it seven days prior to the Urodynamic test as the medication can affect your results. The following is a list of common medication that should be stopped prior to your test, but you may be on a drug for your bladder/prostate that is not on this list. If you are unsure or concerned about stopping any medication do enquire. The number to ring to contact your consultants secretary should be on your appointment letter or alternatively contact Gloucestershire Royal Hospital on Tel: 0300 422 2222, ask for operator when requested and they will direct you to your consultant s secretary. Prostate Medication Alfuzosin (Xatral, Xatral SR, Xatral XL ) Doxazosin (Cardura ) Dutasteride (Avodart ) Indoramin (Doralese ) Prazosin (Hypovase ) Tamsulosin (Flomax, Flomaxtra XL, Combodart ) Terazosin (Hytrin ) Finasteride (Proscar ) Bladder Medication Desmopressin Duloxetine (Yentreve ) Fesoterodine Fumarate (Toviaz ) Flavoxate Hydrochloride (Urispas ) Oxybutynin Hydrochloride (Cystrin, Ditropan, Ditropan XL, Lyrinel XL ) Propiverine (Detrunorm, Detrunorm XL ) Solifenacin Succinate (Vesicare ) Tolterodine Tartrate (Detrusitol, Detrusitol XL ) Trospium Chloride (Regurin, Regurin XL ) Kentera (Oxybutynin transdermal patch )
Page 3 of 5 Before the test, please complete the frequency/volume bladder chart that should be included with this leaflet. This is to record for a minimum of four days: The amount of fluids you drinks in a day What you drink How many times you pass urine What volume of urine you have passed each time, use a measuring jug (you may need to purchase one of these) If you have leaked urine (wet or damp). Remember to bring this chart with you to the appointment, as this information is very useful to know how your bladder is working. Ideally, try to arrive for the test with a comfortable full bladder, as you will be asked to pass urine into a special toilet before the test. Do not worry if you are unable to do this. If you urgently need to pass urine whilst waiting in the clinic please inform the reception staff any they will contact the clinic nurse specialist who will direct you to the special toilet. What does the test involve? You will have a short consultation with the urodynamic nurse specialist managing the clinic. The nurse will ask you some questions about your bladder symptoms and will ask to see your frequency/volume bladder chart which was sent with your appointment. It is important that you fill this chart in as accurately as possible, as this data provides valuable information in gaining knowledge about your problem. The consultation is a good opportunity to discuss any concerns or worries that you may have. The nurse will then explain what is going to happen and will show you the toilet where you will need to pass urine. You will be asked to pass urine privately, into a specially adapted toilet which will record the required information i.e. the rate at which your urine flowed and the amount of urine that was passed. After you have passed urine, the nurse will perform a painless ultrasound scan on your bladder to measure if there is any remaining urine left inside. You will be asked to lie down on a couch and you will need to expose your abdomen. A small amount of gel will be placed on your abdomen and then the scan will be performed. The scan will take only a couple of moments, is painless and non-invasive.
Page 4 of 5 In order to begin the urodynamic test, a fine sensor tube/wire (sterile) will be inserted into your bladder through the urethra (the tube through which urine is passed). Another fine sensor will be placed into the rectum (back passage) or vagina (for women). Placing these tubes/wires should not be painful as a lubrication gel is used to reduce any discomfort. Some patients may find this part of the test slightly uncomfortable or a little embarrassing. The nurse specialist will help to minimise this as much as possible. If you have a colostomy, the rectal tube/wire will be placed into your stoma. Please bring an extra stoma bag with you in order to change the stoma bag after the investigation. If you have a urethral catheter in place, this will be removed for the test. If after the test a new catheter is still required, please bring a spare catheter together with a spare urine bag or valve with you. When the sensor tubes/wires are in place, they are attached to a computer, which measures the bladder activity as the bladder fills and empties. Your bladder will be filled with sterile water through the fine tube until you feel the need to pass urine. You will be asked to cough at various stages throughout the test; this is to ensure that the tubes are recording correctly. The nurse specialist will try to reproduce the bladder symptoms that are currently being experienced by getting you to cough, laugh or listen to running water. When the nurse specialist is satisfied that enough information has been obtained, you will be allowed to empty your bladder on a specially adapted toilet (in private). This toilet will measure the flow rate and volume of urine passed. Once this is done, the sensor tubes/wires will be gently removed and you can have a wash (if you want) and get dressed. How long will the test take? You should allow an hour for your appointment; however, the actual urodynamics test will take approximately 30 minutes. What happens after the test? Following the test, it is advisable to drink extra water for 24 hours, as this will help to dilute your urine and minimise the risk of infection. Aim to drink two to four extra glasses of fluid.
Page 5 of 5 The result of the test will be discussed with you by the urodynamic nurse specialist and if need be appropriate treatment will be discussed. The doctor/consultant, who requested the urodynamics test for you, will receive a report within seven days. You will then receive notification from the doctor/consultant regarding a follow-up appointment, which is normally no longer than six weeks after your test. Can the test be performed if I have my period? If you are expecting your period at the time of the test, it is not necessary to rearrange your appointment unless you are bleeding heavily or if you would prefer the test to be performed at another time. Changing or cancelling your appointment It is important to let us know as soon as possible if you need to change or cancel your appointment. We will then be able to offer you a new appointment at a more convenient time and your original appointment can be offered to another patient. Please contact your urologist consultant s secretary (the telephone number will be at the top of your appointment letter). Alternatively, contact Gloucestershire Hospitals on Tel: 0300 422 2222, ask for operator when requested and they will direct you to your consultant s secretary. Further information We hope that this information helps you feel prepared for the test. If you have any further questions, please contact the consultant s secretary who has organised this test for you (their telephone number should be on your urodynamic appointment letter). The secretary will help answer your questions or will contact the urodynamic specialist for you. Alternatively, contact Gloucestershire Hospitals on Tel: 0300 422 2222, ask for operator when requested and they will direct you to your consultant s secretary.