Urodynamics at Pinehill Hospital

Urodynamics

What does the procedure involve?

Urodynamics is a special test to measure the pressure in your bladder during filling and emptying. It is used to investigate overactive bladder problems and incontinence in women and prostate/bladder problems in men. The procedure is done in the outpatient clinic under local anaesthetic. 

What should I do before the procedure?

  •  If you suspect you have any urine infection please contact us 1 week before the test so we can check and treat any infection. We cannot perform the study if you have active infection in your urine. Your urine will be checked prior to the test.
  • Please ensure that any medication for your bladder symptoms, e.g. Oxybutynin (Ditropan), Tolterodine (Detrusitol) or Solfenacin (Vesicare) is stopped 3 days before your test.
  • Men taking drugs such as Tamsulosin or Alfuzosin for prostate problems should also stop this for 2 days before their test. 
  • After checking for allergies, you will normally be given an antibiotic tablet before the test to prevent infection in your urine. 
  • Please be sure to inform your Urologist before of your test if you have any of the following: 
    o an artificial heart valve
    o a coronary artery stent
    o a heart pacemaker or defibrillator
    o an artificial joint 
    o an artificial blood vessel graft
    o a neurosurgical shunt
    o any other implanted foreign body
    o a previous or current MRSA infection

If you take Warfarin or Clopidogrel (Plavix®) or another blood thinning medication you should stop the medication 5 days before the test. If you have a mechanical heart valve do not stop these drugs until you have discussed this with your specialist ordering the test.

What happens during the test?

  • The test is performed using local anaesthetic gel passed into the urethra (water pipe).  The test will usually be performed by a Consultant Urologist and/or a Specialist Nurse.
  •  On arrival in the department, you will be asked to pass urine into a device called a flow-rate machine so, if you are able to pass urine, please ensure that you arrive with your bladder comfortably full. You will then have a bladder ultrasound scan to check the bladder is empty.
  • You will be positioned comfortably on a couch and small tubes inserted, one into the urethra (water pipe) and the other into the anus (back passage).  We will try and reproduce a normal fill/empty bladder cycle while monitoring your bladder sensation. You will then be encouraged to hold on until your bladder feels quite full.  If one of your symptoms is leakage of urine, we will try to reproduce this so that we can see what the problem is.
  • Although patients find this embarrassing, remember we deal with this all the time and its essential information needed to treat your symptoms.

What happens immediately after the procedure?

When the procedure has been completed you will be able to dress while the results of your test are being analysed. A report will be sent to the referring doctor and a follow –up appointment arranged. Please allow 4-7 days for the reports to reach your doctor. When you go home, we would like you to drink plenty of fluids for the next 24-48 hours to minimize your risk of urine infection.

Are there any side-effects?

The majority of patients do not suffer from any problems after a urological procedure. Minor discomfort with bloodstained urine for 24 -48 hours is the most common.   

Common (>10%)

  • Discomfort on passing urine
  • Bloodstained urine - Occasional (5-10%)
  • Urine infection
  • Inability to pass urine (retention of urine), requiring temporary insertion of a catheter
  • Inability to pass the catheter into the bladder
    Rare (1-2%)
  • Failure to give a definitive diagnosis, sometimes requiring repeating
    Hospital-acquired infection 
  • Clostridium difficile bowel infection (0.1%) 
  • MRSA bloodstream infection (0.08%)

What should I look out for at home after the test?

If you experience lots of blood in you urine, flu-like symptoms, shivering/shaking, any pain/burning when passing urine or a high temperature, you should contact Pinehill Hospital since you may require treatment with antibiotics.  If you are unable to pass urine after the test, you should contact Pinehill Hospital immediately.

Are there any alternatives to this procedure?

There are no non-invasive alternatives apart from simple observation and treatment without the information that this test might produce. If you need surgery for incontinence or for your prostate (men only), this test will improve your chances of having a successful outcome. 

Information for your insurers

If you have medical insurance you should contact them prior to the procedure for pre-authorization.  
The procedure code is M4780.

Who can I contact for more help or information?

Call our enquiry line at Pinehill on 01462 410 002 or call Hertfordshire Urology Associates on 01462 456788.

Additional information

For female patients:
Prior to your test we will ask you to complete a one page questionnaire about the impact of your urinary function on your quality of life.
(UDI 6 and IIQ7 questionnaire)

For male patients:
Prior your test we will ask you to complete a one page questionnaire about the impact of your urinary symptoms on your quality of life.
(IPSS questionnaire)

Mr G Boustead, Consultant Urologist

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