Urodynamic testing is a sophisticated procedure used to help diagnose problems with voiding (urination) and/or urinary incontinence (involuntary loss of urine). It provides accurate information which will help us determine if urinary symptoms are due to blockage, bladder overactivity or both. Many men will benefit from Urodynamics before they undergo surgery on the prostate.

Preparation

There is no particular preparation for a UDT. The only mandatory requirement is that you have had a urine test within the 2 weeks preceding the UDT to ensure that no infection is present. In certain circumstances, we may request that you arrive to the test with a full bladder so that we may do an initial “uroflow”. The uroflow portion of the test is simply where you urinate into a special receptacle so that our equipment can calculate the pattern and force of your stream. If you do not recall being told to do so, please assume that we would like you to have a full bladder.

For women of child-bearing age, it is important that we ensure that you are not pregnant (especially in cases where we use x-rays). Please let us know if there is any suspicion that you may be.

Procedure

The actual procedure typically takes about half an hour. Once your bladder is empty, we will ask you to lie down on the examination table. Under sterile conditions, a very thin catheter is gently inserted through the urethra (the tube through which you urinate) and into your bladder. We may use numbing jelly to minimise the discomfort. With the insertion, you may feel a very slight sting or pinch.

Next, a similar catheter (with a tiny balloon on the end) may be inserted into the rectum or the vagina (much like a thermometer) and the balloon is filled with a small amount of water. Once the catheters are secured in place with tape, we will begin the test. Depending on your circumstances, you may be standing or sitting for the test. In rare instances in which a patient can do neither, the test can be performed with a patient lying down.

The catheters are attached to computers so that we may gather data about how your bladder and urethra function. Your bladder is slowly filled with water until you tell us that you are “full” and have a need to urinate. Throughout the filling, we will be speaking with you so that you may describe the sensations you are having as your bladder fills. You will notice that we are simultaneously watching the graphs and numbers on the computer. When you are full, we will ask you to urinate and empty your bladder into a special container.

In certain instances, we will take x-rays of your bladder during the filling and voiding portions of the test. If we plan to do this, we will use a type of fluid (x-ray dye) to fill the bladder instead of water. Once you finish voiding, the catheters are removed and the test is over.

Post Procedure

After the procedure, you might have a little stinging in the urethra until the next time you urinate. In some patients, it may last a big longer. If there were any resistance to the passage of the catheter, you may even see a tiny blood discoloration of your urine. You have no restrictions after the UDT and may even return to work if you choose.

Possible Complications of the Procedure

Most patients have no problem whatsoever after urodynamic testing. As with any procedure, no matter how minor, complications may rarely occur. These include but are not limited to:

• Urinary Tract Infection or Urosepsis (Bloodstream Infection)
  Even from a minor and sterile procedure, it is possible for you to get an infection with bacteria that typically cause urinary tract infections (UTIs). It may be a simple bladder infection that presents with symptoms of burning urination, urinary frequency and a strong urge to urinate. This will usually resolve with a few days of antibiotics. If the infection enters the bloodstream, you may feel very ill. If you have high temperatures or any symptoms of severe illness (fevers, shaking chills, weakness or dizziness, nausea and vomiting, confusion) let your doctor know immediately, and proceed to the nearest emergency room.

• Blood in the Urine
  In some patients, placing the catheters within the bladder will cause a very small amount (microscopic) of bleeding; in even fewer patients visible bleeding will be noticed in the urine. In almost all instances, the urine clears on its own over the next day or so.

• Urinary Retention
  After a catheter is inserted it is possible for the prostate to swell a little. This may make urination difficult or impossible. Whilst uncommon, urinary retention is more common in men with larger prostates.

Follow-up

Please contact the office within 3 days of discharge. You should make an appointment to see Dr Sved as directed by the doctor performing the Urodynamics test. You may see him in his offices at RPA, Bankstown or Strathfield Private Hospital. Do not hesitate to call at any time if you have any concerns.