Preparing the Patient for Multichannel Urodynamics Testing
Preparing the Patient for Multichannel Urodynamics Testing
This article focuses on patient preparation prior to multichannel urodynamics testing and follow-up care related to the testing procedure. Patients may experience anxiety related to urodynamics testing, and individual counseling with patients and the use of educational brochures or online information explaining the study may reduce anxiety. Expert opinion strongly suggests that urodynamics testing should seek to reproduce bothersome lower urinary tract symptoms (LUTS), and therefore, patient preparation for testing often begins with an assessment of LUTS, either volunteered by the patient or elicited by a written or online form. Completion of a form is strongly encouraged to ensure patients are queried about all potentially relevant LUTS. Antimicrobial prophylaxis should not be routinely administered, but suppressive antibiotics may be beneficial in highly selected patients. Medications prescribed to modulate lower urinary tract function may be discontinued, but some patients should be evaluated while taking these medications depending on the goals of testing. Mechanical cleansing of the bowel on the day of testing is rarely indicated, but management of bowel elimination symptoms is routinely indicated because of the association between lower urinary tract and fecal elimination dysfunction. Instructions and counseling following testing will ensure that the patient has an opportunity to discuss findings. Consumption of additional fluids to reduce transient bacteriuria and taking a warm sitz bath or shower are also encouraged to alleviate any residual discomfort.
Urodynamics evaluation typically combines several studies to measure lower urinary tract function. While International Continence Society Standards of Nomenclature reports do not specify which tests comprise a standard evaluation, assessment usually includes a urinary flow study, filling cystometrogram, and voiding pressure flow study (Abrams, Blaivas, Stanton, & Anderson, 1988; Abrams et al., 2002). Additional studies, such as sphincter electromyography or a urethral pressure profile, may be completed in selected cases. These studies are collectively referred to as multichannel urodynamic evaluation (see Table 1). This article is the fourth in an ongoing series written for the urologic clinician performing urodynamics testing. It focuses on patient preparation prior to multichannel urodynamics testing and follow-up care related specifically to the testing procedure.
Abstract and Introduction
Abstract
This article focuses on patient preparation prior to multichannel urodynamics testing and follow-up care related to the testing procedure. Patients may experience anxiety related to urodynamics testing, and individual counseling with patients and the use of educational brochures or online information explaining the study may reduce anxiety. Expert opinion strongly suggests that urodynamics testing should seek to reproduce bothersome lower urinary tract symptoms (LUTS), and therefore, patient preparation for testing often begins with an assessment of LUTS, either volunteered by the patient or elicited by a written or online form. Completion of a form is strongly encouraged to ensure patients are queried about all potentially relevant LUTS. Antimicrobial prophylaxis should not be routinely administered, but suppressive antibiotics may be beneficial in highly selected patients. Medications prescribed to modulate lower urinary tract function may be discontinued, but some patients should be evaluated while taking these medications depending on the goals of testing. Mechanical cleansing of the bowel on the day of testing is rarely indicated, but management of bowel elimination symptoms is routinely indicated because of the association between lower urinary tract and fecal elimination dysfunction. Instructions and counseling following testing will ensure that the patient has an opportunity to discuss findings. Consumption of additional fluids to reduce transient bacteriuria and taking a warm sitz bath or shower are also encouraged to alleviate any residual discomfort.
Introduction
Urodynamics evaluation typically combines several studies to measure lower urinary tract function. While International Continence Society Standards of Nomenclature reports do not specify which tests comprise a standard evaluation, assessment usually includes a urinary flow study, filling cystometrogram, and voiding pressure flow study (Abrams, Blaivas, Stanton, & Anderson, 1988; Abrams et al., 2002). Additional studies, such as sphincter electromyography or a urethral pressure profile, may be completed in selected cases. These studies are collectively referred to as multichannel urodynamic evaluation (see Table 1). This article is the fourth in an ongoing series written for the urologic clinician performing urodynamics testing. It focuses on patient preparation prior to multichannel urodynamics testing and follow-up care related specifically to the testing procedure.
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