Urodynamic investigation (bladder test)

Introduction

Urodynamic test is the study of the bladder’s ability to hold urine and empty it in a normal fashion.

This investigation tests the pressure and flow in the bladder and the urethra, (the water pipe through which you pass urine). This provides useful information to help decide which treatment will be most appropriate for you.

Who is the leaflet for? What is its aim?

This leaflet is for you if you are having an urodynamic test. Its aim is to inform you about the procedure, what it entails, what you have to do to prepare and what to expect afterwards.

It also gives you contact details should you have any concerns or questions.

Is there anything I should do in advance?

If you have been referred directly to clinic by your GP, prior to meeting your consultant here at Addenbrooke’s, please make sure that you have had a routine sample of urine tested to confirm you are free from an urine infection prior to the test. If you have symptoms of bladder infection, please have this checked (a sample of urine may be required), so you have time for any necessary treatment with antibiotics before coming along to do the test. If there is evidence of urine infection on the day, the test would have to be rescheduled due to the risk of spreading the infection.

If you are on any medication(s) (called anticholinergics or b3 - agonists ) which are used to calm your bladder [i.e. tolterodine (Neditol®, Detrusitol®), solifenacin (Vesicare®), oxybutynin (Ditropan®), trospium (Regurin®), mirabegron (Betmiga®)], please discontinue your treatment 5 days prior to having the test, unless you are told otherwise. Please continue all other medications you might be on, including antibiotics.

If in any doubt about these instructions, you could discuss this with one of our clinic nurses on 01223 216482 (mornings only). If you are unable to contact the clinic directly, you can contact the urogynaecology specialist nurses via switchboard on 01223 245151 and ask for bleep 157-952 or via emailing Weiyi Pan, emailing Alison Thick, or emailing Carolyn Griffiths.

Where do I go to have the test?

Please report to reception at Clinic 21 which can be found on level 1 of the Rosie Hospital or Clinic 25, which is located on Daphne ward on level 2 of the Rosie Hospital (your appointment letter will tell you where to attend).

Do I need to bring anything?

Please bring with you your bladder diary (voiding and volume chart), which would usually have been provided to you at your prior consultant appointment. The bladder diary records how often you pass urine, the measured amount you pass, and if you have had any leaking in a 24-hour period. You are usually asked to keep this recording for three or four complete days. The bladder diary is a very important test that provides further clarity on your symptoms and helps further management. We would very much encourage you to fill one in and bring it on the day of your urodynamic test appointment.

Do I need a full bladder?

You will normally be asked to attend for the tests with a comfortably full bladder. So, if possible, please do not pass urine in the hour prior to your appointment.

If you find travelling with a full bladder uncomfortable and stressful, you may find it more convenient to arrive half an hour before your appointment time, giving you time to drink several glasses of water to fill your bladder.

Does it hurt?

This test is usually tolerated very well and is unlikely to cause pain. You may experience some discomfort, urgency to pass urine or embarrassment.

How is the urodynamic test performed?

In clinic you will meet a nurse trained in urodynamic testing, and possibly a doctor, who will explain what they are going to do during the procedure.

The procedure takes approximately 30 - 45 minutes and does not require any fasting. No anaesthetic is required, but we will use local anaesthetic gel to numb the opening of your urethra. You will be asked to remove your lower clothing for the duration of the test but a disposable sheet will be given to you to wrap around the lower half of your body. Staff will ensure your dignity is maintained at all times.

You will be asked to pass urine into a special toilet that is connected to a computer, which measures how efficiently your bladder is able to empty.

Following this we will ask you to lie on a couch. We will clean the area of the urethra and apply local anaesthetic gel to the opening. A small plastic catheter (tube) will then be inserted into your bladder, along with another fine catheter, so it can be filled with sterile water. Another fine soft catheter will also be inserted into the back passage (the rectum) or into the vagina. These special catheters will record the pressures measured inside your bladder and your abdomen. The catheters are attached to a monitor that enables us to see how your bladder works.

Your bladder will then be filled with sterile water via the catheter in your urethra. During the procedure, you will be asked questions about the sensations you experience in your bladder. You will also be asked to do some exercises which might trigger the problem you are experiencing, (e.g. coughing, straining, standing up or listening to the sound of running water, dipping your hands in cold water). You will also be asked to tell the nurse / doctor when you first think you might like to empty your bladder, and again when your bladder feels full. Do not worry if you leak during the test. This is not urine, but the sterile water we filled your bladder with. In addition, this would help us to understand more about your bladder problems.

Finally, the catheter that was used to fill your bladder with water will be removed and you will be asked to empty your bladder into the special toilet, with the two other fine catheters still in place. The catheters will then be removed and the procedure is complete. We will then ensure your bladder empties completely by performing a bladder scan.

You can have this test when you are menstruating.

What to expect afterwards

For a day after the test, passing urine may sting a little. If you think that you have developed a urine infection i.e. you have increased frequency in passing urine or an unbearable stinging or burning sensation on passing urine, please let your doctor know, and you may be advised to take antibiotics for a short period of time.

You are encouraged to drink plenty of water for the next 24 hours to help ‘flush’ your bladder through, in order to try and prevent any infection developing.

Make sure you have the details of your follow - up appointment.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches), a current repeat prescription from your GP and any cards about your treatment, if your medication requires blood monitoring.

Benefits

• To reproduce your symptoms and provide an explanation for your bladder problems.
• To demonstrate an underlying abnormality of storage (holding onto urine) or voiding (passing urine).

Risks

No matter how carefully the test is performed, urine infections or retention (inability to pass urine) can sometimes occur after it.

Contacts and further information

Outpatient Appointments

01223 217664

(If you cannot attend your appointment for any reason, please call as soon as possible, during office hours Monday to Friday 08.00 – 16.00)

Urogynaecology Specialist Nurses

01223 349239 or Bleep via switchboard 01223 245151 and ask for 157952 or 159216

08.00 – 18.00 Monday to Friday only

Email: urogynaenurses@addenbrookes.nhs.uk

References and sources of evidence

International Urogynaecological Association (opens in a new tab)

Urodynamics: A guide for women (2020) (opens in a new tab)

Privacy and dignity

Clinics 21 and 25 are female only areas.

Every effort will be made to ensure maximum privacy during the test.