Quix or Anybody Who Knows About Urodynamics Testing

I had my urodynamics testing done last week and I'm a little confused by the results. I thought the test was suppose to show all the problems, or reveal all the issues that you are having with incontinence.

Last week, when I had the urodynamics testing done, they hooked me up to a computer. When they started to fill my bladder with water, my bladder would intermittently go from a flat line, and then go into quivers. Sometimes the quivers would be strong. Other times it would be subtle. This would happen through out the test. (Flat line for a while..then spastic.) The lady that was performing the test asked me if I felt it. I said yes, but I've felt it a lot worse at my house. She asked me if it gave me the feeling I needed to urinate. I said yes, but I've come to ignore it when I can. It all depends on how full my bladder is when it starts to spasm. Then it can't be ignored.

The day after the procedure, I felt fine, but the next day my bladder was not happy. It was spastic all day, and all night. When I would take my Baclofen, it would calm things down a little. I had my husband got me some cranberry juice and it seem to calm things too. I use this as a back up, just in case of a UTI is coming on. Yesterday, things felt much better, so I was good to go, but I did have another accident this past weekend. Same scenario..I woke up in the morning, with a full bladder, and I didn't even realize I was urinating until it was too late. I also notice that I'm waking in the middle of the night, just to use the bathroom. It averages about every 3-4 hours, then I have to go.

Today I went to get my results of my urodynamics test. He said that I have stress incontinence. No big surprise there. I've had this problem for awhile, and frankly I didn't need a test to say that I lose urine when I cough or sneeze, etc..He then started talking about fixing the issues with my bladder prolapse. He wants to re-enforce the vaginal walls with mesh,  tack the bladder and attach it to the spine, and sling the ureters to help with the stress incontinence issues.

After he was finished talking about the surgery, I asked him about the cause of me urinating on myself in the morning,  the spasms I get in my bladder, and the urgency feeling I get, which makes me feel I have to go right now. He said that the urodynamics test is not very good at picking up urge incontinence issues, which is what I was describing. (but I thought it did).

I asked him it there was any abnormal neurological findings on the urodynamics test. He said that there wasn't. He said the EMG showed that my sphincter relaxed and tightened when it should have. I asked him about the spasm/quivering that was caught on the computer graph. He said that he did see that, but really made no comment about it. I reminded him that I feel this happen all the time, but the Baclofen does help, sometimes with this issue. He said that sometimes nerves get mixed messages from the brain..but he never explained the cause of this.

I did do research before I went. This is where the confusion is. I looked up several things about spastic bladders/ bladder spasms. He didn't exactly say I had urge incontinence, but bladder spasms is one of the likely causes when speaking of urge incontinence. I also read that it can be neurological in nature..or have a neurological cause. He never really explained anything when it came to me urinating on myself in the morning, without knowing it, or feeling the rhythmic squeezing of my bladder...He just wanted to discuss the surgery. So I left with really no evidence , except of something I already knew I had, but no explanation to the causes of the other issues that has just creeped up within the last 6 months or so.

Can a spastic bladder be another neurological symptom? Isn't bladder spasms abnormal during a urodynamics test? Why couldn't he diagnose me with urge incontinence with what I said (my history of symptoms)? Given my patient history, wouldn't it be more likely that the spastic bladder issue is from a neurological cause? Should the EMG findings be abnormal...and that is why, because he acted like, since this was normal, I was OK, so there was nothing neurological. Isn't a sphincter issue separate from bladder spasms, and you don't necessarily have to have both for it to be neurological? Why can't I catch a break? :(

Sorry for all the questions..I'm so confused!!!!

[slightlybroken]

bum-pity bump

[essdipity]

Hi, SB. I have had all the urodynamics tests, but I really can't help with your questions. They told me mine were abnormal, showed me the graphs and so on. They didn't say which parts were normal, as I imagine some were. I'd think it would be highly unlikely to have
*everything* malfunctioning.

If you haven't yet, get the written report from your tests. Then spend some time on the web checking on the doc's wording. That might make things more clear.

ess

[PastorDan]

I don't know.  This is something about which I've just begun readding within the past month or so, and haven't learned much, but it sounds like this doc is more interested in doing $$$urgery than actually finding and treating the cause of the problems, IMHO.  I didn't catch this from your post: is this a urologist of whom you write?

[slightlybroken]

That's pretty much what my husband said ($$$). It was the uro-gyn I just saw. I do want to get the surgery because I do believe it will help some issues. I don't like having to deal with my recent prolapse bladder. It happened in December.

But I've read that if I do have urge incontinence issues, surgery will not do a thing for this. I do believe I have this problem too. The symptoms of urge incontinence describe me to a tee.

I was just disappointed in the fact that he didn't address the bladder spasms, that I have complained about in the first place, and the loss of urine in the morning without even knowing it's occurring, until it's too late. That to me is disturbing. I already knew about the stress incontinence...didn't need a test to show me that.

[slightlybroken]

Thanks for your input...I didn't think of that. My brain isn't working to well. I had a really rough couple of weeks (emotionally).

Thanks

[Quixotic1]

This guy isn't very educated on neurological problems.  He specializes in structural problems (stress incontinence) and in making money.  I think your instincts are right.  Now that doesn't mean you shouldn't correct the prolapses - 'cause nothing is supposed to be falling out.  If it is done well, then the effect of the neuro problems "might" be lessened.

However, it is possible that the neurological problems should be considered in planning the surgery, I don't know.  But, I am always leery of letting someone operate whose primary goal seems to get you into the OR.  Urologists ARE surgeons primarily.

He sounds undereducated for your purposes.  Where did you get the referral for him?  You might contact a neuro clinic, a spinal injury clinic, or an MS clinic and find if they have a uro-gyne associated with them that might be better versed in the "neurology" of the problem, rather than just the repair problems.  He should have been able to discuss fully the extent to which your bladder spasmed inappropriately.  

Was it spasming out of sequence with the relaxation of the external sphincter?  One of the commonest neurologic problems in MS is Detrusor Sphincter Dyssynergia (the bladder wall muscle working out of rhythm with the tightening and relaxation of the outlet sphincter.)  

Quix

[grannyhotwheels]

I would definetely get a second opinion and get it with someone who knows a thing or two about MS.  We are in a class by ourselves when it comes to any type of medical problems.  At least that's how I feel about it.  Let us know what you do decide to do.

I'll be praying,
Carol

[slightlybroken]

Quix- I got the referral from my OB/GYN. My husband said, he thought he heard that he was just an OB/GYN with them in their office, and recently got his specialty in the URO part. He was nice, but I'm not sure if he knew what to think of me. I'm not sure of your other question..but it was occurring when they were filling my bladder with fluid, and asking me when I would seek out a bathroom. When they started to fill it, it would go from flat-line on the computer, to strong waves of spastic reaction, to flat-line again, to quivers. This happened through out the filling process. Even with a little fluid, it was going crazy, and then back to normal. On certain days I do lose urine when this happens, but that day I had catheters in so, I'm not sure if I did or not. Sometimes, I'm unaware that I do it unless I feel that warm sensation.

My bladder is still fighting me off and on since the urodynamics testing. I'll be fine one day, and other days, my bladder is spastic all day. It did not like this test.

Carol- I think I will get a second opinion. I think I might let him fix my prolapse first, and then after I fully recover, seek someone else who knows more about the neurological end of it. That way, there should only be one issue, instead of two. There has to be a reason for me to just let loose in the mornings,  to have that urge to go "right now", and the spasms that I've been getting. I think it has to be linked to, whatever it is, I have neurological wrong with me. I've only been doing those things for 6-7 months. The stress incontinence has been longer.

[Antalya]

I feel your pain/anxiety/frustration!  I'm just starting to deal w/ the whole urology stuff and hate it.  My urologist didn't even tell me what was going on w/ the cystoscopy.  I was furious. It hurt and I wasn't expecting it.   Next is my urodynamic test..  Reading your post, I wonder what the point of the whole thing is - doesn't seem like you have gotten any satisfaction out of the test. By spasms do you mean kinda extreme cramping?  I have mild cramping on my R side - where I know I have cysts in my R kidney.  Not comfortable and very disconcerting.
I definitely agree that you should get a referral from someone who knows an MS Urologist.  There is no way that I would let someone operate on me w/out a second opinion -  One step @ a time.  
Good luck - hopefully all these posts will help you.

           ----Marcia

[Antalya]

?  it is now 2/13 -  why did this post from 2010 show up @ the top of the forum questions?  How does this work?  Very strange!

          -  Marcia

[SarahL2491]

I don't know but glad it did, I enjoyed Quix's comments and it does describe my urologist!  So I won't do the test when he pushes for it as my last visit indicated I know more about MS than he does!

[PastorDan]

MH's Search function has always mystified me.  I am sure someone understands how it indexes & selects threads to display, and in what sequence.  HELLO, TECH PEOPLE?  A simple explanation or link to one?  Thnx!

[twopack]

I'll try to write a quick tutorial later today and put it on a separate thread.  For now, I'm guessing it was Marcia's new answer that brought this particular old question back to the future.

[PastorDan]

Her answer brought it to the top of the forum, which is normal.  The question (for me) is: Why does "Search" (@top of forum page) return so many very old threads at the top of results?