SPECIAL TEST TO DIAGNOSE YOUR BLADDER PROBLEMS AND URINARY INCONTINENCE

These include frequency, nocturia, urgency, incontinence, enuresis, dysuria, haematuria, voiding difficulty and prolapse.

• Frequency is going to pass urine very often, i.e. more than 7 times per day or less than 2 hourly.
• Nocturia is getting up at night more than once to pass urine.
• Urgency is a strong and difficult to control desire to pass urine.
• Urinary incontinence is a condition in which there is 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, e.g. coughing, sneezing, running or aerobics.
• Nocturnal enuresis is wetting the 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 – only in women – is the sensation or feeling with the fingers or seeing (with naked eye or a mirror) that ‘something is coming down below’ – inside or outside the vagina.

Your doctor will have to obtain a detailed medical history from you, examine you and perform urodynamics, if necessary, to find the cause of your bladder problems before treating you.

Urodynamics are special outpatient tests used to assess the normal and abnormal function of the urinary tract, esp. the bladder and urethra (‘water-pipe’ leading from the bladder to the outside of the body)

These range from the simple to the more sophisticated depending on 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 done in some of those patients who have had previous failed surgery for incontinence. As these two tests are not commonly done your doctor will explain how these are performed if you require them.

Uroflowmetry (Urine flow tests)

This is the simplest of urodynamic tests measuring the rate of urine flow together with the amount of urine passed as a computerised tracing.

You will have to come to the clinic with a comfortably full bladder, pass urine in a modified toilet seat (Micturition chair) into a flowmeter, in total privacy.

Who needs a uroflowmetry performed?

Those women / men who complain of difficulty in passing urine.

RESIDUAL URINE

Immediately after your uroflowmetry we will measure the amount of urine left in your bladder to detect how well you have emptied your bladder.

How is measuring my residual urine done?

This is done by passing a catheter or by ultrasound scanner.

What happens if my uroflowmetry and / or residual urine are abnormal?

You will then require a voiding cystometry to determine the cause of your difficulty in passing urine.

This test will tell us the sensation of your bladder; how much it can hold, how ‘elastic’ it is and the pressure changes when it is being filled up, when you are changing posture, standing up and coughing; 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); you have genuine stress incontinence of urine (stable bladder with stress incontinence of urine demonstrated) or both the latter two conditions.

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