Download Urodynamics 2017 - Chesterfield Royal Hospital

information for patients
Urodynamics
The urinary tract
Your kidneys filter waste chemicals from the
blood to form urine, which passes into the
kidneys’ collecting system and then on to the
ureters and bladder. The bladder is a hollow
muscular balloon-like organ that collects urine
which it stores until you are ready to urinate.
The tube from the bladder to the outside
world is called the urethra. In women, the
urethra is a short tube immediately in front of
the vagina (birth canal). In men, the tube is a
longer one that passes through the prostate
gland and along the penis. A muscle called
the urethral sphincter surrounds the urethra.
When your bladder is storing urine the
sphincter muscle and the pelvic floor
compresses the urethra and keeps you
continent by preventing urinary leakage.
When you urinate your bladder muscle
contracts (squeezes) and the sphincter muscle
relaxes (opens) and urine is expelled along
your urethra.
What are urodynamic studies?
Urodynamics is the study of the pressure of
urine in the bladder and the flow of urine
leaving the bladder which can give useful
information to help work out the cause of
bladder problems. The test measures the
way the bladder contracts to start the flow of
urine and how much pressure there is in the
bladder and urethra (the tube that carries
urine out of the bladder).
Why do I need to have this
examination?
The test is done because the same symptoms
can be caused by different bladder problems
so it is not always possible to make a
diagnosis by talking and simple examination.
What are the benefits of having
Urodynamics?
The test may help to choose an effective
treatment.
It might be that you and your doctor are
thinking about surgery and the test is to see if
an operation could help. Occasionally, the
test is done to see if your bladder pressure is
so high that it could cause kidney damage.
What are the alternatives to having a
Urodynamics?
The alternative is not to have the test.
Urodynamic tests are needed to decide on
treatments aimed at improving your quality of
life rather than improving your life
expectancy. You do not have to have the test
or treatment if you prefer to put up with your
symptoms.
What problems can
Urodynamics diagnose?
An overactive bladder muscle
is where the bladder muscles
contract without you wanting it to creating a
strong desire to pass urine known as
urgency. Urgency can be difficult to
suppress and may require frequent visits to
the toilet or may result in leakage (known as
urge incontinence).
Bladder muscle weakness is when a bladder
is not able to produce a good enough
contraction to empty properly.
Obstruction to the flow can be caused by
many problems including a narrowing of the
outlet tube from the bladder (a stricture) or
(in men) enlargement of the prostate gland
and in women, a prolapse.
Sphincter and pelvic floor weakness can
cause stress incontinence, which is leakage
when you do anything that raises the
pressure in your abdomen, for example,
cough, laugh or take exercise.
information for patients
What happens when I have the test?
Urodynamics is not painful but some people
do find it embarrassing. Try not to worry, we
will do our best to put you at ease and make
sure you are treated sensitively.
When your bladder is full you will be asked to
pass urine again tin the special toilet. This is
usually done whilst you are standing. We
have a special device to catch the urine for
both men and women.
When you have changed in to a gown all you
will be asked to do is lie down on a special
x-ray table that can be tilted into an upright
position.
If you experience leakage please do not worry,
it is all part of the test and you will be able to
wash in the changing rooms at the end. The
fluid you leak is XR dye and does feel a little
sticky.
Some patients are given an injection of an
antibiotic called Gentamicin.
A fine tube, called a catheter, is inserted into
your bladder—through the opening in the tip
of the penis in men and in the small opening
above the vagina in women. You will also
have a second catheter inserted into your
rectum (back passage).
The first catheter is used to fill your bladder
with fluid and is also attached to a sensor that
records the pressure inside your bladder. The
second is also attached to a sensor and it
records the pressure in your abdomen. These
sense bladder pressure and record what
happens when you cough or move around. All
these catheters are linked to a computer that
prints out a graph of all the changes.
Once the tubes are in place, the doctor or
nurse will start filling your bladder. They will
usually ask you to say when you first feel the
need to pass urine and describe how you feel
as your bladder fills. You may be asked to do
a few simple things, such as cough or strain to
test how the bladder sphincter muscle and
pelvic floor behaves when put under stress
from increases in pressure.
Are there any risks
involved?
There is a small risk of infection
from the test. Such infections
are treatable and your doctor will give you
advice if you feel concerned.
When will I get the results?
Your consultant will normally discuss the
findings with you after the test and often again
at a later appointment. Advice and treatment
may then be offered depending on the bladder
problem diagnosed.
What happens after the test?
You will be shown back to the changing rooms
where you will find various hygiene products
for washing. You can go home as soon as you
have changed.
What should I do when I get home?
Drink plenty of water (at least two to three
pints) for the rest of the day and three to four
pints a day for the next day. This will help to
prevent infection.
You can usually resume sexual activity
immediately.
During the test the table will slowly tilt so you
will end up in the standing position, unless you Avoid travelling long journeys for the next
are usually unable to stand up of course. Do two days.
not worry about falling off whilst the table
is moving: it is very safe!
information for patients
General things to
remember:
•
If you think you may have
an infection or feel ill, contact your
own GP or the numbers below
•
If you have been given antibiotics,
make sure you complete the course
•
If you are unsure about the tablets
given to your contact your GP for
advice
•
If you have any problems or are
unsure what to do please do not
hesitate to contact any of the ward
staff for advice.
We hope that you have found this information
useful. If you have any questions, or you are
worried about anything, please speak to your
family doctor (GP) or contact the above
numbers.
You can get copies of this and other leaflets
from our website:
www.chesterfieldroyal.nhs.uk
Do you have special communications
needs?
Speak to a member of staff if you need
interpreting services (including sign language)
at your appointments, or if you would prefer
information in another format.
Who can I contact after the procedure?
If you think you may have an infection or feel
generally unwell, please see your GP who will
refer you back to the hospital if necessary.
If you need further advice contact:
The Urology Department
Monday to Friday 8.30 am — 5 pm
Telephone: 01246 512349
Urodynamics reviewed: April 2015
Next planned review: April 2017
Division: Surgical Specialities