Q1. What are the common bladder problems in men and women?
|
Q2. How can the cause or causes of the bladder problems mentioned above be determined?
|
Q3. What do you mean by urodynamics?
|
Q4. What are the various tests in urodynamics?
|
Q5. What is uroflowmetry?
|
Q6. How is uroflowmetry performed?
|
Q7. Who needs uroflowmetry to be performed?
|
Q8. What is residual urine?
|
Q9. How is my residual urine measured?
|
Q10. What happens if my uroflowmetry and/or residual urine are abnormal?
|
Q11. What is filling cystometry?
|
Q12. What is voiding cystometry?
|
Q13. How are filling and voiding cystometry performed?
|
Q14. Is urodynamics painful?
|
Q15. Are there any preparations required, such as fasting, before urodynamics?
|
Q16. Who needs urodynamics?
|
Q17. Are urodynamics necessary?
|
| ............................................................................................................................................................................................ |
| |
|
| Q1. |
What are the common bladder problems in men and women? |
| A1. |
Common bladder problems in men and women include the following:
-
Frequency: is the passing of urine very often, that is, more than 7 times per day or less than every 2 hours.
-
Nocturia: is a condition where a person has to get up at night more than once in order to pass urine.
-
Urgency: is a strong desire to pass urine that is difficult to control.
-
Urinary Incontinence: is a condition in which there is an uncontrollable leakage of urine causing a social or hygienic problem.
-
Urge Incontinence: is urinary incontinence associated with a strong desire to pass urine.
-
Stress Incontinence: is urinary incontinence caused by physical activity such as coughing, sneezing, running or aerobics.
-
Nocturnal Enuresis: is the condition where a person wets his or her bed during sleep.
-
Dysuria: is a burning or stinging pain while passing urine.
-
Haematuria: is the passage of blood in the urine.
-
Voiding Difficulty: is the need to wait or strain to pass urine accompanied by a poor or intermittent flow.
-
Prolapse: This condition occurs only in women. It is the sensation of, feeling with the fingers or seeing (with the naked eye or in a mirror) that 'something is coming down below' – inside or outside the vagina. |
| |
................................................................................................................................................................................... |
| Q2. |
How can the cause or causes of the bladder problems mentioned above be determined? |
| A2. |
Your doctor will have to obtain a detailed medical history from you, examine you and, if necessary, perform urodynamics in order to find out the cause or causes of your bladder problem/problems before treating you. |
| |
................................................................................................................................................................................... |
| Q3. |
What do you mean by urodynamics? |
| A3. |
Urodynamics are special outpatient tests used to assess the normal and abnormal function of the urinary tract, especially of the bladder and the urethra (the 'water-pipe' leading from the bladder to the outside of the body). |
| |
.................................................................................................................................................................................. |
| Q4. |
What are the various tests in urodynamics? top |
| A4. |
These range from the simple to the more sophisticated depending upon the complexity of your problem. They include:
-
Uroflowmetry
-
Residual Urine
-
Filling and Voiding Cystometry (CMG)
-
Urethral Pressure Profile (UPP) and Video-Cystourethrography (VCU): UPP and VCU will only be performed in some of those patients who have had previous failed surgery for incontinence. As these two tests are not commonly undergone, your doctor will explain to you how these are performed if you require them. |
| |
................................................................................................................................................................................. |
| Q5. |
What is uroflowmetry? |
| A5. |
Uroflowmetry (urine flow test) is the simplest of the urodynamic tests. This test measures the rate of urine flow as well as the amount of urine passed. |
| |
.................................................................................................................................................................................. |
| Q6. |
How is uroflowmetry performed? |
| A6. |
You will have to come to the clinic with a reasonably full bladder (as per what feels comfortable to you), sit on a modified toilet seat (called a micturition chair) and, in private, pass urine in the usual way, into a flow meter. |
| |
.................................................................................................................................................................................. |
| Q7. |
Who needs uroflowmetry to be performed? |
| A7. |
Those men/women who complain of difficulty in passing urine require uroflowmetry to be performed. |
| |
.................................................................................................................................................................................. |
| Q8. |
What is residual urine? |
| A8. |
Immediately after your uroflowmetry, we will measure the amount of urine left in your bladder (residual urine), in order to detect how well you have emptied your bladder. |
|
|
................................................................................................................................................................................. |
|
Q9. |
How is my residual urine measured? top |
|
A9. |
It is measured by placing a bladder scanner over your bladder – a painless procedure lasting only for a few seconds. |
|
|
................................................................................................................................................................................... |
|
Q10. |
What happens if my uroflowmetry and/or residual urine are abnormal? |
| A10. |
You will then require a voiding cystometry so that the cause of your difficulty in passing urine can be determined. |
|
|
................................................................................................................................................................................... |
|
Q11. |
What is filling cystometry? |
|
A11. |
This test will tell us about the sensation of your bladder; how much it can hold, how 'elastic' it is, the pressure changes that take place when it is being filled up, when you are changing posture, standing up and coughing and whether you have any urge or stress incontinence of urine.
Thus, it can help us to make a diagnosis of whether your bladder is stable (normal) or unstable (detrusor instability), whether you have genuine stress incontinence of urine (stable bladder with stress incontinence of urine demonstrated) or both the latter two conditions. |
|
|
.................................................................................................................................................................................. |
|
Q12. |
What is voiding cystometry? |
|
A12. |
This test is performed immediately after the filling cystometry. It is used to differentiate as to whether you have an obstruction of the urethra ('water pipe') or an under-active bladder as a cause of your difficulty in passing urine. |
|
|
................................................................................................................................................................................... |
|
Q13. |
How are filling and voiding cystometry performed? |
|
A13. |
When you arrive for this test you will have to empty your bladder completely, in the usual way, in the toilet. We will then make you lie down on an examination couch, clean you down below using sterile cotton swabs and an antiseptic lotion before inserting a fine tube into your bladder in order to measure your residual urine.
Your bladder will then be gradually filled through this tube with sterile 0.9% salt solution, to mimic urine. Another finer tube will also be inserted into your bladder, together with the first tube, for the purpose of measuring the pressure changes in your bladder through a computer in the urodynamic machine.
We will also have to insert a fine catheter into your back passage for measuring pressure changes in your 'tummy' (abdomen) at the same time. This is to ensure that the computer will automatically calculate the true pressure changes within your bladder (detrusor pressure). Otherwise, any pressure changes in your abdomen, such as changing posture, standing and coughing, will show a false rise in pressure in your bladder.
During the filling cystometry, we will make you sit up on a modified toilet seat and fill your bladder until you finally feel like passing urine. We will then remove the filling tube, make you stand up on a pre-weighed incontinence sheet and cough 10 times so that the absence or presence, and the severity of stress incontinence of urine can be determined.
After this, you will have to sit down on the modified toilet seat again and empty your bladder completely, into the flow meter, to complete the voiding cystometry. |
|
|
................................................................................................................................................................................... |
|
Q14. |
Is urodynamics painful? top |
|
A14. |
Most patients do not find the filling cystometry painful. However, you may feel some discomfort when the two fine tubes are being passed into your bladder and you may feel like opening your bowels when the tube is being passed into your back passage. We will use a lubricating gel to diminish your discomfort. |
|
|
.................................................................................................................................................................................. |
|
Q15. |
Are there any preparations required, such as fasting, before urodynamics? |
|
A15. |
No such preparations are required. However, you should try and open your bowels before your test. We will check your urine to make sure that you do not have a urine infection before booking you for urodynamics. |
|
|
.................................................................................................................................................................................. |
|
Q16. |
Who needs urodynamics? |
|
A16. |
The following people require urodynamics:
-
Those who have difficulty passing urine
-
Those with troublesome stress incontinence of urine that requires surgery
-
Those with stress and urge incontinence of urine
-
Those with complex bladder problems
-
Those who complain of bladder problems after previous gynaecological surgery
-
Those who have had previous failed incontinence surgery |
|
|
.................................................................................................................................................................................. |
|
Q17. |
Are urodynamics necessary? |
|
A17. |
Your doctor will decide whether you need urodynamics after he has seen you. Urodynamics are necessary in those patients mentioned above.
Urodynamics will help your doctor make an accurate diagnosis. This is absolutely essential in order to treat you successfully – especially if surgery is required. |
|
|
top
|
