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Treatments

Urodynamics (Male)

Cystometry (Measurement of Bladder Pressure)

A cystometrogram (CMG) measures how much your bladder can hold, how much pressure builds up inside your bladder as it stores urine, and how full it is when you feel the urge to urinate. The doctor or nurse will use a catheter to empty your bladder completely. Then a special, smaller catheter will be placed in the bladder. This catheter has a pressuremeasuring device called a manometer. Another catheter may be placed in the rectum to record pressure there as well. Your bladder will be filled slowly with warm water. During this time you will be asked how your bladder feels and when you feel the need to urinate. The volume of water and the bladder pressure will be recorded. You may be asked to cough or strain during this procedure. Involuntary bladder contractions can be identified.

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Measurement of Leak Point Pressure

While your bladder is being filled for the CMG, it may suddenly contract and squeeze some water out without warning. The manometer will record the pressure at the point when the leakage occurred. This reading may provide information about the kind of urinary problem you have. You may also be asked to apply abdominal pressure to the bladder by coughing, shifting position, or trying to exhale while holding your nose and mouth. These actions help the doctor or nurse evaluate your prostate and sphincter muscles.

Pressure Flow Study

After the CMG, you will be asked to empty your bladder. The catheter can measure the bladder pressures required to urinate and the flow rate a given pressure generates. This pressure flow study helps to identify bladder outlet obstruction that men may experience with prostate enlargement. Most catheters can be used for both CMG and pressure flow studies.

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Electromyography (Measurement of Nerve Impulses)

If your doctor or nurse thinks that your urinary problem is related to nerve or muscle damage, you may be given an electromyography. This test measures the muscle activity in and around the urethral sphincter by using special sensors. The sensors are placed on the skin near the urethra and rectum or they are located on the urethral or rectal catheter. Muscle activity is recorded on a machine. The patterns of the impulses will show whether the messages sent to the bladder and urethra are co-ordinated correctly.

Video Studies

Urodynamic tests may be performed with or without equipment to take pictures of the bladder during filling and emptying. The imaging equipment may use x rays or ultrasound. If x-ray equipment is used, the bladder will be filled with a contrast medium that will show up on the x ray instead of the warm water. The pictures and videos show the size and shape of the urinary tract and help your doctor or nurse understand your problem and whether it relates to bladder dysfunction, prostate obstruction or rarely, a problem with co-ordination of the urethral sphincter and bladder (sphincter dyssynergia) which occurs most often in spinal injured patients and children with spina bifida.

After the Test

You may have mild discomfort for a few hours after these tests when you urinate. Drinking a large glass of water each half-hour for 2 hours should help. The doctor may give you an antibiotic to take for 1 or 2 days to prevent an infection. If you have signs of infection—including pain, chills, or fever—call your GP at once.