The Best Bladder Check Up

Urodynamics or Cystometrics are fairly straightforward tests of the ability of our bladder to function. When we are having to rush to the bathroom, but don't make it; run to the bathroom too often; have questions about the way the urine actually comes out, it may be time for more than just a simple gyno visit. It maybe time to get a test of the function of your bladder so that treatments can be fine tuned to fix exactly what is wrong. These tests, which has a variety of names including urodynamics and cystometrics are in office tests that are done at many urologists offices and some gynecologists offices. A catheter is placed in the bladder and sterile fluid is instilled.  Cystometry (or cystometrogram) evaluates bladder function by measuring the pressure and volume of fluid in the bladder during the inflow of this fluid, which is equivalent to your kidney filling your bladder from above. Then after the pressure is measured during filling, the amount of urine you can hold known as your storage volume, and the pace you can urinate out the fluid given is measured to check your normal voiding pattern. The actual rate measurements are called uroflowmetry and this measures the rate the urine flows out under these conditions. The urethra needs to have a certain normal tone, that tone is checked with this uroflow system and an entire urethral pressure profile is developed to test tis tone. If the tone is poor then the bladder will leak at very low pressures, and the uroflow testing will give your gyno a measurement of this pressure called a leak point pressure. This leak point pressure determines both bladder pressure at which the leak occurs, and then measures the abdominal pressure when leakage occurs under circumstances where there is increased abdominal pressure such as you straining in a Valsalva maneuver or cough to assess how well the urethra resists the pressure and holds the urine back. It is after this test that your gyno can more accurately determine whether surgery or medicine,or behavior therapy, or a pessary, or a combination should be done.


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