Challenges with urinary incontinence or other problems urinating can be difficult to face. In fact, AdventHealth urogynecologist Lindsay Kissane, MD explains, “Women are often told by their peers that it’s normal or that they should just live with the symptoms, but if it’s affecting your quality of life, there are many effective solutions for a wide range of urinary tract issues.”
But to get to treatments, urogynecologists like Dr. Kissane must first make the correct diagnosis. To do this, one of the tests Dr. Kissane often uses is called urodynamic testing.
Dr. Kissane discusses what urodynamics is and how it can assist in finding effective treatment solutions to help with urinary tract disorders.
How a Healthy Bladder Operates
The urinary tract is made up of the kidneys, ureters, bladder and urethra. The bladder and urethra make up the lower urinary tract and are responsible for storing and expelling urine from your body.
The bladder and urethra work together with the central nervous system to tell the body when to hold and when to release urine. The bladder sits in the pelvis and is in close proximity to other organs, muscles and ligaments that help hold it in place.
The urethra is a tube at the bottom of the bladder that carries urine from the bladder to the outside of the body. When the bladder fills to its limit, the sphincters are signaled by the brain to relax while the bladder muscles contract to expel urine out of the body through the urethra.
But for many reasons, problems can arise with the muscles, sphincters and brain-signaling involved in healthy urine storage and urination.
Problems With the Lower Urinary Tract
Lower urinary tract problems can occur with a range of conditions that may bring the following symptoms:
- Leakage of urine
- Frequent urination
- Painful urination
- Intense urgency to urinate
- Problems with starting the urine stream
- Problems emptying the bladder completely
- Frequent urinary tract infections (UTIs)
Symptoms can be caused by stress urinary incontinence, urgency urinary incontinence and many others.
Getting to a Diagnosis with Urodynamic Testing
Dr. Kissane explains, “The purpose of urodynamic testing is to evaluate how well the bladder and urethra are functioning, as well as how well the brain and lower urinary tract are communicating.”
She continues, “Urodynamic testing is done in the office. The test takes about 45 minutes, and it is not painful. The test is often recommended if a patient has both stress and urgency incontinence and is planning for surgery, if someone has urgency incontinence and medications are not working, or when patients with advanced pelvic organ prolapse are planning for surgery.”
Dr. Kissane further details the steps in urodynamic testing.
First, the patient is instructed to come to the office with a full bladder. There’s generally no other preparation or instructions other than possibly stopping overactive bladder medication for a specified time before the test.
Once at the office, the patient urinates on a commode that can measure the flow of the urine as it comes out.
Subsequently, a very small catheter is placed in the urethra and then in the vagina or rectum. The medical professional administering the test slowly fills the bladder and records the patient’s sensations of the bladder filling and if the bladder is showing any abnormal contractions or leakage.
The patient reports when her bladder is full and then the filling is stopped. The patient then empties her bladder while the catheter measures the strength of the bladder’s muscle contractions. This will show whether there could be an obstruction or other problem with the bladder emptying.
“All of the measures are recorded through the computer which then provides us with a tracking of pressures and volumes that looks similar to an EKG strip. Then, a trained urogynecologist, like myself, can interpret the values to help make a proper diagnosis,” shares Dr. Kissane.
The test offers a lot of diagnostic insight, but does not require general anesthesia, which allows the patient to drive to and from the appointment themselves and have the results immediately.
While other providers may be offering urodynamic testing, one unique aspect of Dr. Kissane’s practice is that the patient has immediate treatment options following testing.
She adds, “We have capacity to perform the test, interpret results and discuss them with the patient, and then plan and implement treatment immediately.”
Dr. Kissane’s Message to You
“Urodynamic testing is just one tool we can use to understand what might be causing your discomfort and symptoms. Our main goal is finding solutions to help, and we have many options, from physical therapy to medications, in-office procedures and sometimes, surgery,” Dr. Kissane concludes.
Dr. Kissane is an experienced urogynecologist at AdventHealth for Women. After medical school, she completed a four-year OB/GYN residency and an additional three-year fellowship in urogynecology. During her fellowship training, she solely treated women with pelvic floor disorders, pelvic organ prolapse, fecal incontinence and urinary incontinence.
Learn more about AdventHealth for Women’s urogynecology services, or click here to make an appointment with Dr. Kissane.