The Urodynamics Procedure

Urodynamics is a computerized evaluation of the body's functions during episodes of incontinence. There is minimal discomfort associated with the procedure and no preparation is necessary.

The procedure has several parts and some may require all testing segments, while others are only necessary to identify the specific type or cause of incontinence.
The test begins by urinating in a special chair to measure the rate and flow of urine. A catheter will be placed to evaluate the amount of urine in the bladder after voiding.

At this point two small catheters will be placed, one vaginally to measure abdominal pressure and one into the bladder. The bladder catheter will be moved to measure the urethral length. The bladder will then be slowly filled. You will be instructed during this filling process to indicate fullness at various times. You will also be prompted to cough and "bear down", etc. to reproduce circumstances that provoke leaking. Once the bladder is full, the measurement process is repeated and you will be allowed to empty your bladder.

The first step is to find the right muscles. One way to find them is to imagine that you are sitting on a marble and want to pick up the marble with your vagina. Imagine sucking or drawing the marble into your vagina.

Try not to squeeze other muscles at the same time. Be careful not to tighten your stomach, legs, or buttocks. Squeezing the wrong muscles can put more pressure on your bladder control muscles. Just squeeze the pelvic muscles. Don't hold your breath. Do not practice while urinating.

Repeat, but don't overdo it. At first, find a quiet spot to practice-your bathroom or bedroom-so you can concentrate. Pull in the pelvic muscles and hold for a count of three. Then relax for a count of three. Work up to three sets of 10 repeats. Start doing your pelvic muscle exercises lying down. This is the easiest position to do them in because the muscles do not need to work against gravity. When your muscles get stronger, do your exercises sitting or standing. Working against gravity is like adding more weight.

Be patient. Don't give up. It takes just 5 minutes a day. You may not feel your bladder control improve for 3 to 6 weeks. Still, most people do notice an improvement after a few weeks.

Some people with nerve damage cannot tell whether they are doing Kegel exercises correctly. If you are not sure, ask your doctor or nurse to examine you while you try to do them. If it turns out that you are not squeezing the right muscles, you may still be able to learn proper Kegel exercises by doing special training with biofeedback, electrical stimulation, or both.

Front View of Bladder
 
Figure 3. Front view of bladder. Weak pelvic muscles allow urine leakage (left). Strong pelvic muscles keep the urethra closed (right).