Urodynamic testing or urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests can help explain symptoms such as: Urodynamic tests are usually performed in urology, gynecology, OB/GYN, internal medicine, and primary care offices. Urodynamics will provide the physician with the information necessary to diagnose the cause and nature of a patient's incontinence, thus giving the best treatment options available. Urodynamics is typically conducted by urologists or urogynecologists.

Purpose of testing

The tests are most often arranged for men with enlarged prostate glands, and for women with incontinence that has either failed conservative treatment or requires surgery. Probably the most important group in whom these tests are performed are those with a neuropathy such as spinal injury. In some of these patients (dependent on the level of the lesion), the micturition reflex can be essentially out of control and the detrusor pressures generated can be life-threatening. Symptoms reported by the patient are an unreliable guide to the underlying dysfunction of the lower urinary tract. The purpose of urodynamics is to provide objective confirmation of the pathology that a patient's symptoms would suggest. For example, a patient complaining of urinary urgency (or rushing to the toilet), with increased frequency of urination can have overactive bladder syndrome. The cause of this might be detrusor overactivity, in which the bladder muscle (the detrusor) contracts unexpectedly during bladder filling. Urodynamics can be used to confirm the presence of detrusor overactivity, which may help guide treatment. An overactive detrusor can be associated with urge incontinence. The American Urogynecologic Society does not recommend that urodynamics are part of initial diagnosis for uncomplicated overactive bladder.

Specific tests

These tests may be as simple as urinating behind a curtain while a doctor listens, but are usually more extensive in western medicine. A typical urodynamic test takes about 30 minutes to perform. It involves the use of a small catheter used to fill the bladder and record measurements. What is done depends on what the presenting problem is, but some of the common tests conducted are;

Standardization

Men with benign prostate hyperplasia are influenced by urination position: sitting improves three measures — namely, the maximum urinary flow rate (Qmax), voiding time (TQ) and post-void residual volume (PVR). Qmax, in particular, improves by an amount similar to that achievable with four alpha-1 blockers, medicines commonly prescribed for BPH. This information offers a non-pharmaceutical way of managing the condition, and shows that urodynamics measurements should use a standardized position, to avoid misleading results.