Is a urodynamic study painful?

[tsr58]

A few years ago I had a cystcopy, which I found extremely painful. When it was recommended that I have a prostate biopsy, I switched to one who works with an anesthesiologist for office-based procedures. I had the prostate biopsy under sedation (Versed); and, more recently, a cystoscopy under sedation in the same office.

Next week, I'm scheduled for urodynamic testing. The PA who will perform the procedure asked if I wanted anesthesia or not. She said it might be "a little embarrassing" (her projection, not mine), but it shouldn't be painful. I told her I'm not worried about embarrassment; just pain. She replied, "Take the anesthesia."

I've since read that urodynamic tests are not at all painful.

Is this true? If there is no pain, I would rather not take the general anesthesia since it inherently involves some risk, as well as the inconvenience of getting someone to drive me home.

Any advice regarding pain?

The uro who did the first cystoscopy a few years ago assured me that it might be "a little uncomfortable, but not painful" -- which I quickly discovered was a lie. I think urologists should all have to undergo these procedures on themselves as part of their medical training.

Thanks.

[knr18bl]

I am male and I self cath at least 4 times a day.  The first few times I cathed, it was a little uncomfortable with a slight and very brief tingling/stinging sensation.  I can cath from either a horizontal or vertical position, but I prefer to be vertical (standing).  I no longer have any discomfort while cathing during or after.  

The nurse will usually use an anesthetic gel while inserting the cath.  The mild discomfort is usually experienced as the catheter passes through the Prostate Gland and the sphincter of the bladder.  Again, that discomfort is brief and very mild.

You'll do fine, for that I am sure.

[Idratherdie]

I was 4 or 5 when I had urodynamics testing. This was in the early 90s. It was traumatic. First of all - I didn't even know I was going to have the procedure done until it was happening, because doctors and parents in the early 90s figured that children my age didn't need to know! Secondly, they didn't tell me anything about the procedure, why I needed it, what they were going to do, how long it was going to last. No anesthesia The nurses held my legs down. My parent held my arms down. It was the most excruciating, violating, frightening, harming thing that has ever happened to me in my entire life. I lay there helpless and held down on the bed screaming and crying in pain, and my parent who held my arms down did nothing to try to comfort me. The nurses acted like I wasn't even there. I still have flash backs to it. I suffer today from the experience. I have flashbacks, I wake up thinking about it. I have nightmares about it. I've never had sex, I can't ever allow anything to be inserted into my vagina - even a tampon - it brings me back to that afternoon on the slab. I can't believe doctors, or anyone, would do this to a child. If you're asking if it is painful, yes. It is extremely painful. It is probably the worst pain you will ever have from a medical procedure. If your child has to have one of these, please do not make them undergo it without general anaesthesia. I certainly would have asked to be asleep, if they even allowed me that freedom of choice.

[Copierce]

I am scheduled to have a urodynamic test tomorrow, I am a male and I am terrified of the catheter insertion.  I want to know what really is going to happen to me, what position i am going to be in, and if I am getting all worked up for nothing.  Thanks.

[tsr58]

Thanks again to all who replied to this thread. Your collective advice convinced me to forgo the general anesthesia, which simplified things, reduced the cost, and avoided a unnecessary risk of complications.

The procedure was simple and painless, no embarrassment. Some discomfort when the nurse inserted the catheter (no topical anesthesia, just lubricant), but not really any more so than the typical experience of getting an IV needle inserted in the wrist. The most painful part was when she yanked the tape off my legs after the procedure was done.

As noted by at least one of you, because verbal feedback from the patient is required during the procedure, I learned today that if I had elected to get the anesthesia, it would only have been for the insertion of the catheter. It was really not a big deal.

Results were reportedly clear, indicating that my bladder is functioning normal. (Same finding from the cystoscopy two weeks ago.) So the doctor added Detrol to the Sanctura XR (which worked at first, but lately I've had some recurrences.)

Anyway, this website is a great resource, but only because of people like yourselves who take the time to respond.

Best wishes to you.
  

[keyzersoce]

Good luck!

[tsr58]

I called my uro's office today and rescheduled the test to 2/11 (a week sooner) without anesthesia, thanks to the reassurances and info posted here.

[tsr58]

Thanks to all here for the informative and supportive posts.

Rachy1, you're a sweetheart. Your description of a lifetime of self-catheterization strikes me as courageous, though you may not see it that way. If you can manage that, I can certainly endure this one-time deal without sedation. I imagine urethral catheterization is equally uncomfortable and unpleasant for both genders.

I'll leave the decision up to the PA; agreeing to proceed while fully conscious if she thinks my responsiveness to questions would be useful.

"What a wonderful thing, to be conscious! I wonder what the people in New Jersey do." -- Woody Allen

[rachy1]

They might just numb the area before inserting tubes hun ... I cant see you being knocked out as such as you need to be aware .. Im sure they will just put a numbing gel on your bits..

I have a gel at home to use before self cathing .. it also helps open the uretha before inserting catheter .. Honestly you wont be in any pain hun just a little uncomfortable ..
x

[tsr58]

I understand what you're saying and don't know. From what I've read, they ask things like describing urge strength, etc. However, a search for  shows that anesthesia is a commonly used option both for urodynamics and cystoscopies. (I know I would never have a cysto without one again!)

I had a radical prostatectomy 2 1/2 years ago, with recent increased nocturnal incontinence. Cysto two weeks ago was clear; showing no adhesions, indications of UTI, or other problems. "Sanctura" has been helping lately.

I'm scheduled for this urodynamic business on the 18th as a follow-up to the cysto. As noted in my original post, the PA invited me to opt for the Versed IV due to my questions and apparent anxiety. Although I am curious to observe the procedure; and, after having been through an RRP and all that led up to it and followed it, I'm fairly immune to embarrassment in a doctor's office, history leads me to suspect that I may have an unusually sensitive urethra. I think I'd rather not be there when she sticks the tubes into me.

[keyzersoce]

I had a urodynamics test and don't understand how you could take one under anesthesia. You have to respond to questions the nurse or PA is asking about how you feel during the test. I found the test uncomfortable, but definitely bearable, but then again, I don't thinkhave a problem with a cystoscopy.

[rachy1]

Do you have bladder retention or over active bladder?

My bladder is in complete retention .. the urodynamics show that the actual bladder do not contract at all ?? They then told me that i have to self cath perminant.I did not have any anethesia but i was used to cathetorizing anyway. You get to watch everything as you sit on your thrown (loo) hehe!! You have a catheter fitted to uretha and bowel you feel a little cold sensation whilst they fill it but thats all.. they then ask you to cough and bare down and measure the amounts that you pass.. I didnt pass a thing and was filled to 800ml.. they tell you if you get uncomfortable they will stop. they also explain everything as they go along. You will then go into a room with urologist and they give results right away.   I also had a cystoscopy .. that was more unpleasant ;(

Good luck hun.. Hope all goes well!

Rachy x

[tsr58]

I was supposed to have it done this past week, but had to reschedule due to a snowstorm. It's now on for Feb. 18th. Embarrassment isn't an issue for me. If I weren't fearful of pain, due to past experiences with urethral sensitivity during catheterization and cyscopy, I think I would find the test interesting to watch.

The more I think about it, the more I'm thinking I'll stick with the anesthesia plan.

Check out the thread "Pros and Cons of Urodynamics and Ways to Minimize Pain" on the web at "snipurl *******/b40od" (sorry, but this board doesn't seem to allow posting of external links in messages).

Thanks for your note. I will post an update after it happens.

[rachy1]

Theres a video on youtube .. a bit out of date but it will help :)
Let us know how you get on hun
x

[rachy1]

I had this done bk last summer .. its just a little uncomfortable and embarrasing .. not at all painful, you will be fine hun.. It dont take long and is well worth it.

[tsr58]

Thanks for your reassuring reply.

You say, "The procedure usually causes minimal pain or discomfort..."

Can you compare a man's experience of "pain or discomfort" with urodynamic testing to that of a systocopy? Say a systoscopy is a 10 (maximum) on a pain/discomfort scale, can you compare by rating 1 to 10 the experience of urodynamic study?  

My PA advised me to "take the anesthesia" for the urodynamics, but I suspect my apparent anxiety over the procedure was a factor. If I am assured that it is not painful, I would decline the Versed.

Obviously, anxiety is a factor. But gathering information in advance, and asking hearing others' experiences, helps me to cope with that.

Thanks for your patient reply.

[Dr_Veena]

Hi,
    Thanks for writing in. Urodynamic study is the study of the bladder and urethra activity. It usually involves a series of tests that measures the pressure in the bladder and the flow of urine through the urethra.

Usually a local anesthetic gel is used at the urethra, which acts an anesthetic agent and as well as a lubricant to pass the catheter through the urethra. The procedure usually causes minimal pain or discomfort, but does not require general anesthesia.
Hope this information helps.
Best.