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More Urinary Incontinence Diagnosis
Urodynamics uses physical measurements such as urine pressure and flow rate as well as clinical assessment. These studies measure the pressure in the bladder at rest and while filling. These studies range from simple observation to precise measurements using specialized equipment.
Assessment of Urethral Function
A cystogram is a radiograph (X-ray image) of the bladder. In this procedure, a solution containing a radioisotope (contrast media) is instilled into the bladder via a catheter until the bladder is full (or the patient indicates that the bladder feels full). X-ray images are then taken of the bladder while full and during or after urination.
A cystogram helps to confirm a diagnosis of stress incontinence, the degree of mobility of the urethra, and the presence of cystocele (a condition occurring in women in which the wall between the bladder and vagina weakens and allows the bladder to droop into the vagina, which may cause discomfort and problems with emptying the bladder). These radiographs (X-rays) also may demonstrate problems with the sphincter muscle (intrinsic sphincter deficiency). The presence of an abnormal connection between the bladder and the vagina (vesicovaginal fistula) also may be documented in this fashion.
Electromyography is a test to evaluate potential nerve damage. This test measures the muscle activity in the urethral sphincter using sensors placed on the skin near the urethra and rectum. Sometimes the sensors are on the urethral or rectal catheter. Muscle activity is recorded on a machine. The patterns of the impulses will show whether the messages sent to the bladder and urethra are coordinated correctly.
Cystoscopy, examination of the inside of the bladder, also is indicated for patients experiencing persistent irritative urinary symptoms or blood in the urine (hematuria). The cystoscope has lenses like a telescope or microscope which allow the doctor to focus on the inner surfaces of the urinary tract. Bladder abnormalities, such as a tumor, stone, and cancer (carcinoma in situ) can be diagnosed with cystoscopy. Urethroscopy can be performed to assess the structure and function of the urethral sphincter mechanism.
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