Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
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Subject: Re: urge incontinence I'm a 28 yrs. old female with no children. I had always an urge to go to the bathroom since I was borned. Until I was 18 yrs. old I bedwett at night. The problem I have now is the urge to go to the bathroom and I leak somo urine if I don't hurry up. The doctor want's to perform a cystometrogram, an I.V.P. and a cystoscopy with urethral calibration, he think I may have obstructure to voiding. Can you tell me what is the last procedure, (the urethral calibration). does it hurt?, would I need anesthesia?, and how is it performed. Thnks a lot!!!!
__ Dear Maria, It is very likely that you have urge incontinence that was present from your childhood. I think you need to make sure that you dont have a urinary tract infection first and then proceed with your doctors suggested work-up. The CMG will tell you if you have an unstable bladder for which there are medications, or other neurologic lesions which may require further study. You may even wish to try these anticholinergic medications before proceeding with the more invasive portion of your work-up The IVP is always a good study to look for anatomic abnormalities and will let your doctor know the function of the kidneys. And finally, the cystoscopy will rule out any bladder pathology which might be responsible for your symptoms. I think a post void residual would also be an important piece of information along with a voiding pressure flow study. Before a urethral calibration or dilation is done, these pieces of information might be useful to show improvement after such an operation. If your symptoms improve and these test have not been done, you will never know what caused your problem or if an obstruction was ever present. On the other hand, if you dont wish to know what caused your problem, and you simply want the fastest removal of your symptoms, a urethral dilation is low risk but has controversial results. I dont know what the protocol for sedation is at your hospital or what your doctor follows, but urethral calibration could be painful. Depending on the amount of dilation proposed, the more dilation, the more pain. It is performed by passing dilating sounds through the urethra in succession. The sounds are larger and larger with each pass until the doctor is satisfied. If you were in pain, the doctor could always stop. These questions about sedation you should ask the doctor performing the operation. Overall, I think your doctor is on the right track. Often a full urodynamic work-up includes a CMG, pressure flow study and a post void residual. You would need to be awake for this portion of the evaluation, but could be sedated after for the cysto and calibration. This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
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