Urodynamic testing is a golden standard for evaluation of the lower urinary track function. Evidence based indications for the evaluation and treatment, as well as the thorough evaluation of patients are expected standards which health professionals have to meet. Urodynamic testing has become a routine in diagnostics of bladder and urethral dysfunction, with a wide application in urology, gynecology, pediatrics and geriatrics.
The conditions in which the urodynamic testing is indicated are:
- neurogenic bladder
- stress incontinence
- urgent incontinence
- subvesical obstruction in men
- complications following the prostate surgery
- various types of retention
- dysfunctional urination in children
Urodynamic testing is more uncomfortable than painful. In order to measure the inner pressure, it is necessary to insert thin catheters in a bladder and in a colon. Bladder is slowly being filled with water and patient’s sensations are registered. Once the bladder capacity is reached, the patients is asked to urinate so urine flow can be measured. At the end, the volume of residual urine is measured.
As in every diagnostic, the urodynamic testing starts with talking to a patient, including detailed information about the goal of urodynamic testing and procedure itself.
Prior to every urodynamic testing, it is necessary to prepare the patient:
- urine test should be regular (non pathological)
- night before the colon should be evacuated (Dulcolax suppository)
- patient should not urinate two to three hours before urination so the urge for urination is strong
The average time for urodynamic testing is 2 hours.
Adjacent to the urodynamic testing are the services of the urogenital rehabilitation, consisting of specific therapeutic exercises, electrostimulation of bladder, stimulation with magnet and biofeedback and psychosocial support. Urogenital rehabilitation is available only after the urodynamic testing.