Children with spina bifida or other neurologic abnormalities often
have problems with the urinary system. Some patients have trouble
controlling urination (incontinence). In some patients, the bladder
is unable to empty when it is full. In other patients, the bladder
can empty only partially. Besides causing urine leakage, bladder
problems can also cause urine infections and potential kidney damage.
In order to tell how well the urinary system works we use urodynamic
Normally two kidneys filter the blood to produce urine. The urine
drains down into the bladder where it is stored. The sphincter (control
muscle) wraps around the urine channel and squeezes to hold the
urine in the bladder. When the bladder is full, the sphincter relaxes
to open the urine channel and the bladder muscle squeezes to empty
In some patients these two muscles (the sphincter and the bladder
emptying muscle) squeeze at the same time. This can cause dangerous
pressure in the bladder. In some patients the bladder muscle cannot
squeeze to empty the bladder. In order to tell how both of these
muscles are working, we do three tests:
Uroflow - If a patient can urinate, we do this test
to see how much urine comes out of the bladder and how fast
the urine empties. The patient urinates into a special toilet
to make the measurements. After the uroflow, a catheter is put
into the urine channel to see if any urine is left in the bladder.
Urethral Pressure Profile - With the catheter in the
urine channel we can measure how tightly the sphincter (the
control muscle) can squeeze.
- Cystometrogram (CMG) - A catheter with two openings
is put into the bladder. Through one opening we can measure pressure.
We can fill the bladder with sterile water through the other opening.
A separate catheter is put into the rectum to help us measure
pressure in the abdomen. While the catheter is in the bladder
we measure how much the bladder holds and how hard the bladder
muscle is squeezing. This helps us to know if the bladder fills
easily and whether the bladder puts any strain on the kidneys.
Preparation for the Testing
Doing the urodynamic testing while a patient has a urine infection
can be dangerous. If your child has cloudy or strong smelling urine
or a fever, please call the nurses before the testing (708/216-6266)
so that the urine can be checked and any infection can be treated
before the urodynamics test.
On the day of the test it is helpful if your child drinks extra
fluids about an hour before the test. This will help assure that
the bladder is full for the first part of the test (the Uroflow).
Children are often nervous about medical tests. Sometimes they
are nervous because they don't know about the testing and how it
is done. Sometimes they are afraid that a test will hurt. We will
explain the testing ahead of time. Talking to your child about the
test may help him/her to ask questions. Once the catheters are in
place, the testing takes about 30 to 45 minutes. This can be boring
for a child. It may help to bring some books, some music tapes or
a videotape. Any activity which your child can to while sitting
or lying would be fine.
During the Testing
You are welcome to stay with your child during the testing.
After the Testing
If your child can feel during urination, he/she will probably
feel burning and stinging with urination for one to two days. Sometimes
children's pain medication (Tylenol, Motrin, etc.) can be helpful.
You should use the dose recommended on the package no more often
than every four hours. Sometimes sitting in warm water in the bathtub
If your child has fever, pain in the abdomen, nausea, vomiting,
cloudy or foul smelling urine, she/he may have a urine infection.
Please call the your doctor if any of these symptoms occur.
Even though the testing is finished in an hour or two, analyzing
the results will take a few days. You will be contacted by your
physician with the results. Please ask questions about the testing
and the results and be sure to make a follow-up appointment with
your doctor for treatment that may be necessary depending on what
the results show.
The information on the Loyola University
Health System (LUHS) Web site is for educational purposes
only. It is presented in summary form in order to impart general
information relating to certain diseases, ailments, physical
conditions and their treatments. The information provided
through the LUHS Web site should not be used for diagnosing
or treating a health problem or a disease, nor is it a substitute
for professional care. Should you have any health-care related
questions or suspect you have a health problem, you should
consult your health care provider. See also Copyright