Urodynamics is a study that assesses how well the bladder and urethra store and release urine.
It is important to note that some prescribed treatments are not as effective as others as doctors advocate treatment based on their patient's complaints. Unfortunately, these symptoms are often subjective, and doctors may not arrive at the root cause.
Dr Warren Lo, a consultant urologist in Gleneagles Hospital Kuala Lumpur, discusses more about urodynamics and runs through five patient scenarios that are commonly seen by urologists.
Urodynamics consists of a range of tests to assess the function of the urinary tract. Urodynamics investigations can clearly show the bladder's various conditions such as overactivity or underactivity, besides identifying the underlying causes for various types of urine leaks. They also pinpoint urinary obstructions and reflux conditions, which are risky to the kidneys.
Urodynamics is recommended for various bladder dysfunctions secondary to spinal cord injuries, brain pathologies such as stroke, Parkinson's disease, and other unresolved bladder conditions. It is also indicated for paediatric congenital spinal conditions such as spinal bifida and myelomeningocele.
The investigation involves a relatively simple procedure. Tiny catheters are inserted into the bladder and anus to assess the bladder capacity, pressure, stretchability, sensation, and various stages of leakage. The reflux of urine into the kidneys and bladder outlet obstructions can be clearly shown in this test.
Urodynamics is also indicated for patients who have had previous operations for urine leaks but still persistently leak post-op. For bladder dysfunction and prostate enlargement patients, it is valuable to determine whether the prostate surgery will benefit the patient as sometimes the patient may not be able to pass urine even after an operation due to a weak bladder.
Urodynamic tests do not involve anaesthesia and usually take 30 to 45 minutes to complete. The test is not painful or causes much discomfort, although the patient may feel the catheter being inserted. It is usually done as a daycare procedure with the patient will be discharged on the same day.
SCENARIO 1 |
I was diagnosed with recurrent urinary tract infection (UTI) 5 years ago. But strangely, most urine test results are negative. During that time, various doctors have given me multiple antibiotics. However, the urgency and frequency of urination have never gone away. Is there anything wrong with me? |
SCENARIO 2 |
I was diagnosed with an overactive bladder as I often present with urinary urgency and cannot hold my urine for longer than an hour. I have been treated with various drugs for my overactive bladder. However, the problem seems to worsen every time I take my medications. |
SCENARIO 3 |
I had four uneventful vaginal deliveries. My babies were healthy, but I have since suffered from urine leaks. I was informed that I suffered from urinary incontinence because of my weak pelvic floor muscle. I went through six months of intensive physiotherapy, but the problem persists. |
SCENARIO 4 |
I was diagnosed with Parkinson’s disease three years ago and began to experience issues with urinary incontinence. I was told it was related to my prostate enlargement. After taking prostate medications for three months, the leaking was gotten worse. I am concerned. |
SCENARIO 5 |
Recently, I was involved in a traffic accident and now suffer from an incomplete spinal cord injury. I have issues with recurrent urinary tract infections. I feel I am unable to empty my bladder, but doctors just continue to prescribe antibiotics for me. I think something is not right. |
The importance of urodynamics testing cannot be over-emphasised. It is invaluable for various types of bladder dysfunctions which are often overlooked or understated. Urinary problems can be sensitive, and many urinary complaints can be subjective and present differently from what they really are. In this situation, nothing could be more helpful than being able to pinpoint the source of the problem as well as investigate the underlying causes. Urodynamics testing provides this platform. Speak to your urologist if you have persistent bladder issues that cannot be resolved – identifying the root cause through urodynamics would help to put you on the right treatment plan.
Written by
Consultant Urologist
Gleneagles Hospital Kuala Lumpur
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