Urodynamic Procedures in the Bladder Clinic, ( Nephrology Unit), KEMH

We take for granted the elimination of liquid waste in the form of urine from our body. However, it is possible because of the very important storage and voiding functions played by the urinary bladder. Uroflowmetry and urodynamics are used to evaluate these functions by measuring the pressure and flow generated by the urinary bladder. Children need evaluation for voiding problems due to neurogenic causes eg. A spinal defect they are born with (meningomyelocele) or abnormal patterns of voiding due to non-neurogenic causes. Some boys are born with a membranous blockage in the urethra and even though this is corrected surgically, they need to be followed up closely with frequent evaluations of the bladder. This evaluation and management instituted early, may delay progression to end stage kidney disease.

Adult patients require evaluation of the urinary bladder when affected by trauma to the spine, obstructive uropathy or in patients with diabetes mellitus with neurogenic involvement. For patients scheduled for a transplant, it is an important pre transplant requirement. In addition, neurological conditions like strokes and paralysis from a variety of causes would have bladder involvement as one of the features.

Uroflowmetry serves as a preliminary bladder evaluation as it is a non-invasive test. It measures the volume of urine passed, the speed and the duration over which it is passed. The test can indicate problems with bladder emptying or under-activity of the bladder muscle or presence of obstruction to the normal flow of urine.

Urodynamics is an invasive test involving catheterization of the bladder and electromyography of the muscles that form the pelvic floor. This helps in looking at how well the bladder, urethra and sphincters are coordinated and the pressures that are generated. The test focusses on the bladder’s ability to hold urine and empty steadily and completely and whether or not the bladder is having involuntary contractions causing urine leakage.

Time: With prior appointment
Place: Bladder Clinic, 5th Floor, Diamond Jubilee Building, KEM Hospital, Pune
Contact number: 020 2621 7603
Team: Dr. Yogesh Sovani, Dr. Priyanaka Randive, Sister Murkute