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Urodynamics Studies (UDS)

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When is Urodynamic Study (UDS) necessary?

• Before surgery for urinary incontinence with visible vaginal prolapse.
• If medical and or conservative treatments fail.
• If there has been previous surgery for stress incontinence or bladder prolapse and urinary symptoms continue.
• To identify why you are having problems with your waterworks

Your Consultant has requested that you have a test called Urodynamics. This is to understand the bladder function. The test takes approximately one hour.

What the test involves
No special preparations are needed. You can eat and drink as normal, come with a comfortably full bladder. When you arrive we will explain the test to you and ask you to tell us briefly about your current symptoms. Please complete the enclosed urinary diary in the week prior to your appointment. This involves measuring and recording the amount and type of fluid you drink, and the amount of water you pass.

What is Urodynamics?
Urodynamic Study (UDS) is a study of bladder function.
1. To check how quickly and how well your bladder empties.
2.Bladder compliance i.e. how well the bladder muscle stretches to increase bladder size as it fills.
3. How the bladder responds to increase in abdominal pressure, for example, on coughing.

We will review your bladder diary chart and the questionnaire we sent to you with this leaflet.

Every effort will be made to preserve your privacy and dignity during the time spent with us.
• We will then ask you to undress from waist down and wear a gown. We will ask you to pass urine into a special toilet called a flow meter. This measures how the urine flows and the amount you pass.
• The nurse will scan your bladder with a small hand held probe to see if there is any urine left behind.
• The nurse will then pass 2 very fine tubes (pressure catheters), one in the bladder and one in your back passage. This will feel uncomfortable but not painful.
• One tube consists of a filling tube and also measures the pressure within the bladder, the tube in the back passage measures abdominal pressure.
• This information is sent to a computer to be recorded during the test and is seen at the time.
• The bladder is filled slowly with sterile water. We will ask you to tell us how your first sensation is and when you would normally want to go to the toilet.
• When your bladder feels full we will stop filling and remove the tube from the bladder. We will ask you to do some gentle exercises or cough to see if you leak urine.
• Please don’t feel embarrassed if you feel wet down below as sometimes this happens. You will be asked to pass urine again into the special toilet. The tubes (catheters) will be removed and the investigation is complete.

Where will the test take place?
The test will take place on Treatment centre at the Milton Keynes University Hospital NHS Trust.

How long will the test take?
We make every effort to keep to time and you should expect to be at the hospital for one hour. After the Urodynamic Study is completed we will briefly explain the results to you and tell you what will happen next. You may need a follow up appointment with your Consultant in the outpatient clinic where the results will be discussed with you and your treatment options.

Special Instructions:
1. One week before your test stop taking any tablets you take for bladder problems such as: Oxybutinin, Detrusitol, Tolterodine and Vesicare and Betmiga unless you have been told otherwise by your gynaecologist. Please continue to take medication for you blood pressure and heart problem or any other medication you have been prescribed.

2. If you have a urine infection on the day of your test we will not do the test. If you have a urinary infection at the time of the appointment please cancel and re arrange appointment on 01908
997005.

3. If you are having a period Urodynamic Study can still be performed if you wish. Please call the urogynaecology nurse specialist if you have any queries.

4. We will send you a bladder diary to fill in. It is very useful for us to know how much you drink and how often you pass urine. We would also like to know if you leak, how often it happens. Please
complete this two –three days, preferably when you are at home. If you are at work and unable to measure the urine just write the time.

Are there any risks after Urodynamics test?
• Frequency passing urine more often
• A slight discomfort when passing urine.
• Traces of blood in the urine
All these symptoms are temporary and should go away within 24hours.

Please drink plenty of clear fluids (up to 2 litres per day) for the next 24-48 hours. If your urine becomes cloudy or offensive (smelly) and you feel generally unwell contact your GP.

What are the benefits?
This test will form part of the total assessment of your bladder problems and will help the Consultant to decide on accurate diagnosis and treatment for your condition.

Patient Comments
• ‘All staff were professional, helpful and friendly which made me feel less anxious’.
• ‘Excellent treatment by all’.
• 58% of patients found the test went better or much better than expected
• 88% of patients are willing to have the tests done again if needed.

If you have any questions about the urodynamic test please contact:
Urogynaecology Nurse Specialist Tel: 01908 660033 Bleep:1863

If you need to change the appointment time please contact:
The Treatment Centre Reception Desk Tel: 01908 243727
Colposcopy, Hysteroscopy and Urogynae Secretary/Patient Pathway Coordinator Tel: 01908 996318

Useful contacts
Association for Continence Advice http://www.aca.uk.com
Department of Health http://www.dh.gov.uk
NICE www.nice.org.uk
SIGN http://www.sign.ac.uk

References
Understanding Female Urinary Incontinence (2005) by Dr P. Toozs-Hobson and Professor L. Cardozo. Published by British Medical Association. Available from Local Chemist.

Bladder and Bowel Foundation- Provides information and support for people affected by bladder and bowel problems. Tel: 01536 533255. www.bladderandbowelfoundation.org

The cystitis and overactive bladder foundation gives support to people with all forms of cystitis and overactive bladder. Telephone: 01908 569160 www.cobfoundation.org