Urodynamics is a diagnostic study that allows determining the function of the lower urinary tract. That is, it helps to determine the existence of alterations in bladder filling or emptying.
This is an outpatient exam, this means that the person arrives for the exam and at the end of it can go home. It is performed in an office specifically designed to perform this type of procedure.
This exam consists of several phases, depending on what you want to investigate.
Uroflowmetry
In which it consists of the initial phase and the person is asked to urinate normally in a container similar to a toilet in a bathroom, which is specially designed to measure the amount of urine eliminated and the speed (flow) with which it comes out. In some patients this is all the study that is requested
Cystometry or Cystomanometry
It is the second phase, in which a probe is placed in the urethra (duct through which urine comes out of the bladder), and another at the rectal level, with these probes they are used to measure the pressures of the bladder and abdomen, at turn to fill the bladder with sterile water.
This allows, through a computerized recording, to measure how urine is stored in the bladder, as well as to measure the activity of the bladder muscle called the detrusor. At the beginning of the study, the person is asked to cough or strain to determine if the elements are working correctly.
On certain occasions, instead of sterile water, it can be combined with contrast medium, which is a substance that helps to take X-ray exams. and to be able to visualize the bladder and know if there is return of urine to the kidneys, this study is called video-urodynamics.
Simultaneously, small patches are placed next to the rectum and leg to measure the electrical activity of the pelvic floor muscles, which is called electromyography.
Finally, the urethral catheter comes out and the urethral pressure, urethral length is measured and it is observed if there is urine loss when coughing, this last part is called the urethral profile.
In which case is it indicated to carry out this type of study?
Many diseases have an impact on the urinary tract:
- Male and female urinary incontinence.
- Neurological diseases that affect the urinary tract.
- Diabetes Mellitus with difficulty urinating either male or female.
- Cerebrovascular disease. (embolisms)
- spinal cord injury. (Paralysis – paraplegia or quadriplegia who cannot walk secondary to accidents, tumors, etc.)
- Prostatic growth (prostatic hyperplasia with a history of Parkinson’s, diabetes, multiple sclerosis, strokes.)
- Degenerative diseases (Parkinson’s, multiple sclerosis)
- Children with voiding dysfunction and neurological diseases
- Recurrent urinary tract infection.
- Women operated on for urinary incontinence and who persist with the incontinence problem.
- Women who have urinary incontinence with a history of pelvic radiotherapy, incontinence surgery.
What possible complications and sequelae can there be with this urodynamic test?
Generally, the test is very well tolerated, generating minimal discomfort after its completion. In some cases there may be urine with a small amount of blood which improves with abundant fluid consumption.
Complications such as urinary infection occur in less than 2% of people (2 out of 100) and are manifested by fever, chills, burning to urinate and increased urinary frequency. The recommendation is to contact the doctor who ordered it or go to an emergency room to be treated.
Recommendations for performing the urodynamic study
- Attend accompanied by an adult
- Proper hygiene of the genitals
- Bring recent urine test result
- Attend with light clothing
- Come with the desire to urinate (drink plenty of fluids 2 hours before the exam)
- Bring order of the exam and authorization of the Health Company if it is pertinent
- Antibiotic will be indicated at the time of requesting the appointment if required
- Arrive 10 minutes before the appointment time for reception
Dr. José Manuel Otero García.
General Urology, Neurourology and Urodynamics, Endourology and Percutaneous Surgery
IG: @urologo_dr.otero
He graduated with honors as a medical surgeon and obtained third place in his generation at the National Autonomous University of Mexico.
Later he completed his internship at the National Mexican Institute of Social Security at the General Hospital of zone number 56, where he also obtained recognition for his commitment despite his short experience as an undergraduate medical intern.
Social service is carried out at the National Autonomous University of Mexico in Mexico City.
Presents the National exam for applicants to medical residencies ENARM in the year of 2000, being approved choosing the specialty of surgery, doing in the year of 2001 the first year of general surgery in the Regional General Hospital of the area in Orizaba Veracruz, where he later presents a selection exam to compete for one of the 12 places nationwide, being accepted at the Centro Médico Nacional Siglo XXI where he finished his specialty in 2006.
He was working at the Mexican Social Security Institute from March 2006 to August 2013.
He was an assistant professor of the specialty of urology from 2006 to 2013 and is currently an assistant professor of the specialty of urology at the ABC Medical Center, recertified by the Mexican Council of Urology.
In 2016, he completed a high specialty in Neuro Urology and Urodynamics at the Autonomous University of Nuevo León.
He has more than 15 years of experience as a Urologist, and more than 6000 patients operated on
satisfactory way.
Related Notes: