You don’t have to ‘live with a problem’

Millions live with bladder problems, but there is no reason to “live with the problem.” If you are experiencing symptoms of bladder issues it’s time to talk to a health care provider. It’s time to find a way to live symptom free and urodynamics may help you do just that.

Urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. The tests determine how well your lower urinary tract works. Your lower urinary tract includes the bladder (which stores urine) and the urethra (which is the tube that carries urine from your bladder to the outside). This is the only form of testing we have to look at the function of the lower urinary tract.

Urodynamic tests can help explain symptoms such as: incontinence, frequent urination, sudden or strong urges to urinate but nothing comes out, problems starting a urine stream, pain, problems emptying your bladder completely or recurrent urinary tract infections.

The test lasts for approximately 30 minutes and most urodynamic tests do not involve special preparations. Depending on the test, a person may be instructed to arrive for testing with a full bladder.

Urodynamic tests range from simple observation to precise measurements using sophisticated instruments. For simple observation, a health care provider may record the length of time it takes a person to produce a urinary stream, note the volume of urine produced, and record the ability or inability to stop the urine flow midstream. For precise measurements, imaging equipment takes pictures of the bladder filling and emptying, pressure monitors record the pressures inside the bladder, and sensors record muscle and nerve activity.

There are more extensive tests if your doctor suspects that the nerves may be seriously damaged or that the muscle is not responding appropriately, but further tests are not done routinely.

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.

Points to remember

The urinary tract is the body’s drainage system for removing wastes and extra water.

The lower urinary tract includes the bladder and urethra.

Urodynamic testing is any procedure that looks at how well the bladder and urethra are storing and releasing urine.

Most urodynamic tests focus on the bladder’s ability to hold urine and empty steadily and completely.

There are several types of Urodynamic tests to measure pressure and flow.

What are the complications of retaining urine?

Urinary tract infection – Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. When urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract.

Bladder damage – If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract.

Chronic kidney disease – If urine backs up into the kidneys; permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too much of your kidney function, you will need dialysis or a kidney transplant to stay alive.

What are the treatment options?

Treatment is based on results of the testing. This may require physical therapy or behavioral modification. There may also be a need to add medication. The last option that some people require is surgical correction. Many people require a combination of the above, as each individual is different.

What’s normal?

Ask yourself:

Do you go to the bathroom more than every three to six hours in a day?

During the night, do you have the urge to go to the bathroom more than once?

Do you leak when you cough or sneeze?

Do you go to the bathroom and then feel the urge to go again?

Do you feel the urge to go to the bathroom then nothing comes out?

For more information on Urodynamic testing, go to www.unitypointfortdodge/org or call UnityPoint Clinic OB/GYN at 574-6870. The urodynamic studies are exclusive to the UnityPoint Clinic OB/GYN in Fort Dodge.

Dr. James Turek is a graduate of Creighton University and the University of Nebraska College of Medicine. He joined UnityPoint Clinic Obstetrics and Gynecology in June 2009 and is board certified in obstetrics, gynecology and advanced laparoscopic surgery. He also specializes in urogynecology.