Urodynamic Testing

Urodynamic testing is often done to evaluate how your urethra and bladder are functioning. Urodynamic testing is done by trying to recreate your bothersome symptoms or problems. At the same time it gives additional measurements on how your bladder and urethra are functioning. This information helps your diagnosis and treatment options. This test can be a part of a comprehensive evaluation prior to considering pelvic floor or reconstructive surgery.

People are typically referred for urodynamic testing if they have:

• Urinary incontinence
• Urinary urgency or frequency
• Retention of urine
• Pelvic prolapse
• Difficulty with urination
• A back-up of urine to the kidneys
• Suspected obstruction of the lower urinary system (bladder or urethra)
• Neurogenic bladder (a neurological diagnosis and related urinary problems)

Testing is also sometimes done before organ prolapse surgery to see if there are hidden bladder problems, such as stress urinary incontinence, that can be corrected at the same time.

Plan to arrive at the lab with a comfortably full bladder, but do not drink an increased amount of fluid just before the test.

Continue to take your regular medications. You may have a light meal before the procedure. You may need to take antibiotics in advance if you have had a heart infection, a heart-valve replacement or recent joint replacement surgery.

It is not necessary to bring a driver for your appointment. You will resume normal activities immediately after urodynamic testing.

The procedure takes about an hour, and will be performed by a specially-trained nurse and your physician. Your physician will interpret the results and discuss them with you.

You may experience mild burning or discomfort during urination following the test, but that should go away within 24 hours.

Urodynamic testing involves:

• In the procedure room, you will be asked to urinate into a special commode that measures how much and how fast you urinate. A urinary catheter is then inserted into the bladder to measure any remaining urine.  When the bladder is completely drained, the catheter is removed. 
• Inserting a special urodynamic catheter into the urethra and bladder. Another catheter is placed into the rectum or vagina. These catheters measure pressure. Other sensors measure volume and flow rates. 
• Taping patches to the skin near the rectum to record pelvic muscle activity. This is an EMG or electromyelogram, and can give information on whether the muscles are relaxing and responding appropriately.
  
• Filling your bladder with sterile fluid to evaluate for bladder capacity, bladder elasticity, bladder sensations, unsafe bladder pressures, bladder contractions, or urinary leakage. You may be asked to cough or bear down during the test. You will also be monitored for your sensations and what you are experiencing. Your comfort and safety are a priority.
  
• The final part of urodynamic testing is a comprehensive measurement of voiding. How your bladder squeezes or contracts will be measured while you urinate, and measurements of the urine flow are taken.

For more information, or to schedule a urodynamic test, contact one of our pelvic floor experts. Urodynamic testing is performed by Una Lee, MD, Alvaro Lucioni, MD, and Ksenija Stefanovic, MD, in the Section of Urology. Call your doctor’s office for questions or to make an appointment.

Urodynamic testing is performed in three locations at Virginia Mason:

• Virginia Mason Medical Center in Seattle, Section of Urology: 206-223-6772
• Virginia Mason Franciscan Health Medical Pavilion - Federal Way, Section of Urology: 206-223-6772

Video urodynamics is advanced urologic testing that allows for comprehensive evaluation of the lower urinary tract. It is called video urodynamics, not because a video is taken, but because “video” is Latin for “I see.” With live fluoroscopy images, we are able to see in real time what the bladder and urethra do while the bladder fills and empties. We can see if the urine backs up to the kidneys, visualize leakage episodes in relation to the anatomy, and visualize abnormalities of the urethra or bladder. Video urodynamic studies are valuable in patients with complex urologic symptoms or history, including prior surgery. Video urodynamic testing is considered standard of care for patients with bladder conditions related to neurological diseases (neurogenic bladder). 

Virginia Mason Franciscan Health (VMFH) urology is a referral center for video urodynamic testing by urologists and specialists from around the Pacific Northwest. Your urologist may refer you to VMFH for this special testing only, with follow up with your regular urologist.

Video urodynamics is done in our state-of-the-art urodynamic lab. We have two urodynamic suites with private bathrooms and changing areas, and highly trained nurses who make the experience comfortable for you. The Section of Urology offers urodynamic testing daily to accommodate patient scheduling needs.

Video urodynamic testing is performed in the Section of Urology at Virginia Mason Medical Center: 206-223-6772