Mater Pelvic Health-Mater Medical Centre
Suite 4, Level 2
25 Fulham Road Pimlico 4812
Phone: 4766 3699 Fax: 4766 3696

MID STREAM URINE

Your G.P, Specialist or Health Professional may ask you to provide a Mid Stream Urine sample to be sent off to the pathology laboratory for testing. This is to check for any infection or abnormal cells in your urine.


FLUID DIARY

This may also be referred to as a fluid summary chart, bladder diary or input/output chart. For the fluid summary chart you will need to monitor your daily fluid intake and measure the amount of urine you have passed. The standard cup is 250mls, to measure your urine volumes you can place a container in the bottom of your toilet bowl and use an old jug to measure or you can purchase a Specipan (measuring device) from the chemist.

EXAMPLE:      MONDAY      TUESDAY

1 HOUR PAD TEST
This test is used to quantify your loss of urine and can be done in the privacy of your own home. It is a good idea to do this prior to staring any treatment for urinary incontinence and repeating the test 16 weeks after later to show what improvement you have made.

You can use any type of pad - just place in a plastic bag and weigh on your kitchen scales before you start and at the end of the test return pad to plastic bag and weigh again. Record both measurements and the urine loss is the difference between the 2 measurements.

1 HOUR PAD TEST

This test is used to quantify your loss of urine and can be done in the privacy of your own home. It is a good idea to do this prior to staring any treatment for urinary incontinence and repeating the test 16 weeks after later to show what improvement you have made.

You can use any type of pad - just place in a plastic bag and weigh on your kitchen scales before you start and at the end of the test return pad to plastic bag and weigh again. Record both measurements and the urine loss is the difference between the 2 measurements.

NAME: DOB: DATE: //20

1. Start with a comfortably full bladder.
2. Drink 500mls of water (ASAP).
3. You then need to put on a pad that you have first weighed
4. After 30 minutes go for a 15-minute walk.
5. You will then be required to perform a series of exercises, exactly 1 hour from drinking the water.

• Do knee bends x 10 or sit/stand x 10
• Cough x 10
• Pick up heavy shopping bag x 10
• Step ups (on to stool) x 10
• Jump x 10
• Place hands under running water for 2 minutes

6. Remove the pad and then re-weigh it.
7. You can then go to the toilet and empty your bladder.
8. Record.

Urodynamic studies and flexible cystoscopy

Urinary symptoms like incontinence (leakage of urine), frequency, dribbling etc. do not accurately tell the doctor what may be wrong with you. Urodynamics is a study of the function of the bladder and urethra (water pipe). To be continent the pressure in the bladder is lower than the pressure in the urethra. Urinary incontinence results when the pressures are in reverse. Urodynamic studies enable the pressures to be measured during the filling and emptying phases as part of a total assessment of your bladder problem. This enables the team to make an accurate diagnosis and treat the cause, it even avoids unnecessary surgery. Also it guides the surgeon as to what may happen to the bladder after surgery.

When Do You Need Urodynamics?

Not everyone with bladder problems needs urodynamic studies. They're most useful where: There may be a mixture of symptoms, or uncertain symptoms Where an operation may be considered and the doctor wants to make sure it is necessary and will be helpful Previous treatment has not improved the problem eg physiotherapy or medication.

What is involved?

Uroflowmetry: Patients are asked to attend with a full bladder so on arrival to the clinic they pass urine into the uroflow. This device measures the volume passed, maximum and average flow rate and voiding time. Once completed the residual bladder volume is measured using a bladder scanner.

Filling Cystometry: A fine catheter is inserted into the vagina and a monitoring catheter into the bladder. The catheters transmit pressure changes to the computer so that these can be monitored throughout the filling of bladder during the test. The bladder is filled gradually with normal saline and the patient is asked to indicate sensations felt e.g. normal desire to pass urine, urgency etc. During this phase we monitor for any detrusor (bladder) contractions that would be indicative of over active bladder (OAB) which causes Urge incontinence. Also during this filling phase the patient is asked to cough or push down into the pelvic floor to record changes to bladder pressure whilst increasing abdominal pressure, this resembles the changes that occur during coughing, sneezing etc. As the bladder fills urine leakage is monitored and assessed to accurately diagnose OAB or USI (urinary stress Incontinence).

Urethral pressure profile: At the end of fill the bladder catheter is slowly removed and as it comes through the urethra the pressure is measured.

Voiding cystometry: The final part of the testing is monitoring the function of bladder emptying. This is achieved by voiding with the catheters in place whilst sitting on the uroflow. This records voided volume, peak flow, average flow, voiding time and detrusor (bladder muscle) activity. Catheters are removed and urodynamics is complete. A cystoscopy is then performed.

What is a Cystoscopy?

Cystoscopy is an examination that allows the inside of your bladder to be viewed by your doctor. An instrument called a cystoscope which includes a lens with a fibre-optic light is inserted through the urethra (the tube that drains your bladder) this enables the doctor to view the bladder wall. During this procedure photos of your bladder will be taken.

At all times during the test we ensure privacy and dignity is maintained.