CYSTOMETRY

NANCY L. BRIONES
BSN-III

CYSTOMETRY
CYSTOMETROGRAM (CMG)
a test that measures the pressure inside the

bladder in order to see how well the urinary

bladder is working.
done when a muscle or nerve problem may be

causing problems with how well the bladder

holds or releases urine.

PURPOSE:
To find the cause of the problem affecting the bladder sphincter or

the bladder itself.

To measure how much urine can the bladder store and how much

residual volume there is.

To help the physician and the patient herself make decisions about

the appropriate treatment regimen.

To see how well the bladder works in people with progressive

neurological diseases like multiple sclerosis.

HOW THE TEST IS PERFORMED:

1. Patient will be asked to void into a special container

(UROFLOWMETER) that is interfaced with a computer.

.

It records the (1) time it takes one to begin urinating; (2)

the size, force, and continuity of ones urinary stream; (3) the
amount of urine; and (4) how long it took one to empty ones
bladder.

2. Patient will then lie down and a catheter is gently placed in

her bladder to drain and measure the remaining urine.

A smaller catheter is sometimes placed in ones rectum

in order to measure the abdominal pressure. Measuring
electrodes, similar to the sticky pads used for an EKG, are
placed near the rectum.

UROFLOWMETRY

HOW THE TEST IS PERFORMED:

3. The catheter is then filled with sterile, room-temperature water

while a tube used to monitor bladder pressure (CYSTOMETER) is

attached to it.
.
Water flows into the bladder at a controlled rate. Patient
will be asked to tell the health care provider when she first
feels the need to urinate and when her bladder is completely
full.
4.

Each time bladder is filled, patient will be asked to report when she
first feels the urge to urinate. Patients bladder will then continue
to be filled until she reports that she feels like voiding.

5. Then the catheter will be used to drain the bladder, or patient may

be asked to urinate.

CATHEETR

CYSTOMETER

URODYNAMICS
A three-fold procedure that involves different tests including:
1. Measured voiding without a catheter
2. Filling phase Test
3. Emptying phase test

.For

complete urodynamic testing, a much smaller catheter is

placed in the bladder so the patient will be able to urinate around
it. Because this special catheter has a sensor on the tip, the
computer can measure the pressure and volumes as the bladder
fills and as the patient empties it. Patient may be asked to cough
or push so that the health care provider can check for urine
leakage.

MICS
Type of urodynamic test wherein x-rays can be taken

during the test. In this case, instead of water, a

special fluid that shows up on x-ray is used to fill
ones bladder rather than water or air.

HOW TO PREPARE FOR THE TEST:

Generally, no special preparations are needed for

this test. However, for infants and children,

preparation depends on the child's age, past
experiences, and level of trust.
Before the test, patient must tell the healthcare
provider if she is taking any medicines because some
meds and herbal supplements can affect bladder
function. (e.g. ANTIHISTAMINE)
Patient should also inform the healthcare provider if
she is pregnant or is suspected to be.

HOW TO PREPARE FOR THE TEST:

Healthcare provider should also be notified by the

patient if she has symptoms of a urinary tract

infection: pain or burning with urination, foulsmelling or cloudy urine, or an urge to urinate more
often than usual.

CYSTOMETRY
The test usually takes 30 to 60 minutes, but it may take

slightly longer if any special tests are done.

After cystometry, one will need to keep track of how
much she drinks and how much she urinates for the
next 24 hours. A burning sensation during urination is
a common but temporary side effect. Drinking lots of
fluids will help relieve this sensation. One may be given
an antibiotic to help prevent a urinary tract infection.
One may feel sore after the test though a warm tub
bath may be helpful to relieve the soreness.

RISKS OF CYSTOMETRY:
Cystometry usually does not cause problems though

there is always a slight risk of developing a UTI when

a catheter is inserted into the bladder.
If patient has a high spinal cord injury, she may have
low heart rate, high blood pressure, headache, and
feel flushed or sweaty during the test. Report these
symptoms to the health professional conducting the
test, since further testing may cause complications.

WHAT TO DO AFTER THE TEST:

Patient

may need to urinate frequently, with some burning during and after
urination for a day or two. Therefore, patient must drink lots of fluids to
help minimize the burning and to prevent a urinary tract infection.

pinkish tinge to the urine is common for several days after cystometry.
But call the doctor immediately if:

urine remains red or you see blood clots after voiding X times
have not been able to urinate 8 hours after the test.
have a fever, chills, or severe pain in your flank or abdomen
have symptoms of a urinary tract infection:

Pain or burning upon urination.

An urge to urinate frequently, but usually passing only small quantities of urine.

Dribbling or leakage of urine.

Urine that is reddish or pinkish, foul-smelling, or cloudy.

Pain or a feeling of heaviness in the lower abdomen.

RESULTS:
NORMAL
The rate at which urine flows from
yourbladderwhen you urinate is
normal.

ABNORMAL
The rate at which urine flows from
your bladder when you urinate is
slower than normal, or your urine
stream starts and stops.

The amount of urine left in your

The amount of urine left in your

bladder after you urinate (residual

bladder after you urinate (residual

urine volume) is less than 30mL.

urine volume) is more than normal.

The point at which you first feel the

urge to urinate is within the normal
range, when the amount of liquid in
your bladder is between 175-250
mL.

You have trouble starting the flow

of urine.

RESULTS:
NORMAL
The point at which you feel you must
urinate is within the normal range,
when the amount of liquid in your
bladder is between 350-450 mL.

ABNORMAL
The point at which you first feel the
urge to urinate is more or less than
normal or does not occur.

The maximum amount of liquid your

The maximum amount of liquid your

bladder can hold is within the normal

bladder can hold is less than normal

range: 400-500 mL.

or you can't feel it.

Tests of the function of the nerves

that control your bladder are normal.

Normal sensations and reactions do

not occur when the nerves that
control your bladder are tested.

Urine does not leak from your bladder Urine leaks from your bladder during
during thestress test.

the stress test.

CAUSES OF ABNORMAL RESULTS:

Enlarged prostate
Multiple sclerosis
Overactive bladder
Reduced bladder capacity
Spinal cord injury
Stroke
Urinary tract infection

CYSTOMETRY

Intra-abdominal pressure (Pabd) is measured with an intravaginal or intrarectal pressure

catheter. Bladder pressure (Pves) is measured with an intravesical catheter. Subtraction of
Pabd from Pves yields the true detrusor pressure (Pdet). Fluid can be instilled into the
bladder through a separate channel in the intravesical channel. Bladder contractions that
occur as the bladder is filling and that the patient is unable to completely suppress indicate
detrusor instability.