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Thread: urodynamics

  1. #1

    urodynamics

    what are urodynamics and should you have this done if you have a foley cath.....

  2. #2
    Senior Member rdf's Avatar
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    It meausres pressure on your bladder and determines how much if any urine is being back-flushed to your kidneys. It also determines how much is optimal for your bladder volumes. If you haven't had one, you should get one if you have a sci.
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  3. #3
    Im not sure about the foley catheter part since they had me have my foley out for about a week and had to do ic cathing.I would ask your uro what he thinks since as far as I know they want the catheter out of the bladder for atleast 5 days so your bladder can be as close to normal as it was without the catheter and mine asked me to stop all bladder medicines for about 5 days as well since it makes it harder to urinate.
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  4. #4
    Actually, if you have an indwelling catheter, and plan to keep this long term, there is little value in doing urodynamics testing. We don't do it unless the person does bladder management by reflex voiding or intermittent cath. For people who use these methods, it is recommended every 2 years or more often if there is an increased rate of UTI or the bladder changes somehow.

    For people with SCI, ideally you should have videourodynamics. Not all labs offer this, but it is well worth making the effort to get this type of study.

    You are positioned on a special table, sometimes in stirrups. A small (usually 6 Fr.) catheter is inserted into your bladder. It has a transducer at the outside end, and is used both to fill your bladder with a radio-opaque solution (which should be warmed to close to body temperature), and to measure the pressures in your bladder. It is hooked up to a special computer to do the recording and to control the filling. You are also fit with a device to collect and measure any urine that should leak during the study.

    You also have a small catheter with a balloon inserted into your rectum (be sure you do bowel care before you go). This measures intra-abdominal pressures, which the computer will subtract from your bladder pressure to get your true bladder (detrusor) pressures.

    You will then also have an electrode (either surface or fine needle) applied to the area between the urethra and anus on the outside of your body. This is an EMG electrode used to measure the electrical activity of the pubococcygeal muscle, of which the external urinary sphincter is a part.

    As solution goes into your bladder, the video part is periodic fluorscopy images (captured with video Xray) of your bladder, urethra and ureters. The catheters measure pressures, contraction of the bladder, and coordination of the external sphincter with the bladder. Only with the addition of the video component can you see reflux (if it occurs) and any bladder neck problems (failure to open when the bladder contracts is the most common problem).

    Done properly, the entire set up and test takes 60-90 minutes. At the end, it is strongly encouraged that you get a single IM dose of antibiotic. You should also have a urine culture BEFORE the test, and if needed, pre-treatment with antibiotics should be considered prior to doing the test, even if you don't have symptoms.

    If you have an indwelling catheter, and are considering getting it out, it should be removed 5 days prior to the test to let your bladder normalize first.

    If you are at risk for AD, you should be monitored for this (blood pressure monitoring) throughout the test, and if necessary, medications used to control this until the study can be completed.


    (KLD)

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