Video urodynamics is a diagnostic test that examines how the bladder and urethra function during urine storage and release. It combines pressure-monitoring equipment with simultaneous X-ray imaging to create a comprehensive picture of the lower urinary tract’s activity. This allows a healthcare provider to observe the bladder’s behavior and measure pressures as it fills and empties.
Purpose of the Test
A physician may recommend video urodynamics to investigate a variety of urinary symptoms. It is often used for individuals experiencing urinary incontinence to distinguish between different types. The test helps differentiate stress incontinence, where leakage occurs during physical exertion, from urge incontinence, which involves a sudden need to urinate followed by leakage.
The test is also valuable for diagnosing issues related to bladder emptying. If a person has difficulty starting a urine stream, a weak flow, or feels their bladder is not emptying completely, this test can identify underlying causes. These symptoms, sometimes referred to as urinary retention, can be evaluated in detail.
Video urodynamics is frequently employed when a neurogenic bladder condition is suspected. This refers to bladder problems stemming from neurological damage, such as that caused by a spinal cord injury, multiple sclerosis, or Parkinson’s disease. It is also used to investigate frequent urination, painful urination, and recurrent urinary tract infections when other tests have not provided a clear diagnosis.
The Video Urodynamics Procedure
Preparation for a video urodynamics test is minimal, though you may be asked to arrive at the appointment with a comfortably full bladder. The procedure begins with the placement of small, thin tubes called catheters. One catheter is inserted through the urethra into the bladder, and a second, smaller catheter is placed into the rectum to measure pressure within the bladder and abdomen.
Once the catheters are in place, the bladder is slowly filled with a sterile, liquid contrast medium that is visible on X-rays. This allows the imaging equipment to capture clear pictures of the bladder as it expands. During this process, you will report sensations like the first urge to urinate and the feeling of fullness, which helps determine the bladder’s storage capacity and elasticity.
Throughout the test, you will be asked to perform simple actions like coughing or bearing down. These actions help determine if certain activities cause urine leakage or affect bladder pressure. The real-time X-ray video, known as fluoroscopy, records the bladder’s shape and the movement of the bladder neck during these maneuvers.
When your bladder feels full, the filling catheter is removed, and you will urinate into a special commode that measures flow rate and volume. Imaging continues during this phase to observe how the bladder and urethra function during emptying. While catheter insertion can cause mild, temporary discomfort, the procedure is well-tolerated. Afterward, you may need to urinate more often or see a small amount of blood in your urine, which resolves within a day.
Understanding the Results
The results of a video urodynamics test provide a detailed analysis by correlating pressure measurements with visual evidence. The pressure sensors provide specific data on bladder capacity and compliance, which is the bladder wall’s ability to stretch. The test can detect involuntary bladder muscle contractions that may cause urge incontinence or an overactive bladder.
The video component provides an anatomical and functional assessment that pressure readings alone cannot. The X-ray images show the bladder’s shape and position during filling and voiding, which can reveal structural abnormalities like a dropped bladder (cystocele). The imaging is effective for observing the bladder neck and urethra, showing whether they close properly to maintain continence or open to allow urination.
This combined approach is effective for diagnosing complex urinary issues. For instance, the video can show if urine is leaking from the bladder and at what pressure that leakage occurs, helping to pinpoint the type of incontinence. It can also identify vesicoureteral reflux, a condition where urine flows backward from the bladder toward the kidneys. By integrating pressure data with real-time visuals, your doctor can make a more precise diagnosis and create a targeted treatment plan.