At your first visit to our office, you will have an interview followed by a physical exam. The examination will include a thorough evaluation of the pelvic organs and pelvic floor musculature as well as an assessment for the presence and severity of vaginal prolapse. The exam also includes a post-void residual in which a small catheter is inserted into the urethra after urination to see how well you empty your bladder. Your urine will be collected and analyzed for infection and blood and will be sent to a lab for further testing, if indicated.
Depending on your history and exam findings, additional testing may be ordered. Most urogynecological evaluations include urodynamic testing and/or cystourethroscopy. These tests are performed by specially-trained healthcare professionals and are done in our office.
Occasionally, additional diagnostic testing such as an ultrasound, CT scan or MRI may be needed. These are done at a radiology center or in the radiology department of a hospital. The results of all testing will be reviewed with you at your final or surgical consultation appointment.
Complex Urodynamic Testing
The two main purposes of urodynamic testing are to reveal the cause of abnormal bladder functioning and to determine how the bladder may function after urogynecological surgery. The causes of urinary symptoms are not always as obvious as they might seem. It is important to know the true underlying causes of urinary problems so that appropriate treatment options can be selected. Information on how the bladder may function after surgery is necessary for surgical planning.
Urodynamic testing usually takes 30 to 45 minutes. Small pressure catheters are inserted into the urethra and vagina. The bladder is slowly filled with saline. At various points during bladder filling, you will be asked to cough and strain to determine your ability to hold urine without leaking. At the end of the test, you will be asked to urinate with the catheters in place so that we can assess how you empty your bladder.
The purpose of cystoscopy is to visualize the urethra and bladder to detect anatomical defects, stones, tumors, inflammation, sutures from previous surgeries or other abnormalities that may be contributing to your urogynecologic problem.
Cystoscopy is usually completed in less than five minutes. A small catheter-like instrument with a camera will be inserted through your urethra into your bladder. The image will be projected onto a monitor in the room. Rarely, a bladder biopsy may be needed.