Investigations

Specialist Continence Investigations are available at both Gloucestershire Royal Hospital and Cheltenham General Hospital and include the following:

Uroflowmetry (Urine Flow rates)

The purpose of urowflowmetry is to establish the presence of normal or abnormal urine flow.

Commonly used as a first line investigation in the assessment of Lower Urinary Tract Symptoms (LUTS), the urine flow rate is a simple non invasive test that is quick and simple for the patient to perform.  The patient passes urine into the funnel of the flow machine. The flow machine records the voided volume and flow rate and then gives a printed copy of the results.

Many smaller hospitals (Stroud, Cirencester, Dilke, Lydney, Tewkesbury, Bourton-on-Water and The Vale), also have a flow machine in their out patients department.

Standard Urodynamics (Pressure Flow Studies)

The purpose of pressure flow studies is to assess bladder function during bladder filling and emptying, this information can then be used to help to form a diagnosis of bladder dysfunction.

Standard urodynamics is an invasive investigation, which requires a sophisticated machine and a specialist to administer the test and interperate the results.  The investigation is only available at GRH.

 Video Urodynamics

Video urodynamics is the same investigation as above, with the added benefit of x-ray screening (which takes place periodically during the test).  This test has the advantage of being able to identify the anatomy of the lower urinary tract at the same time assessing detrusor function (the test takes about 30 minutes)

Video urodynamics is usually reserved for more complicated patients, where there is a high chance of anatomical abnormality coexisting alongside bladder dysfunction. 

Again this investigation requires a sophisticated urodynamics machine, x-ray facilities, a radiographer and a specialist to administer the test and interpret the results.  For these reasons, this investigation is only available at GRH or CGH.

Ambulatory Urodynamics

In contrast to standard urodynamics, ambulatory urodynamics uses natural bladder filling (via air filled catheters) as a way of assessing bladder function.  During this test the bladder and rectal/vaginal catheters are attached to a small body worn computer.  The patient is then free to walk around for the duration of the investigation (2-3 hours), which means they are more likely to reproduce the activities which cause their symptoms.

This investigation is used when other urodynamic investigations have not confirmed a diagnosis.  At the present time, patients requiring this test are referred to “The Bristol Urological Institute” at Southmead Hospital.

 Pad Testing

The purpose of pad testing is to quantify the degree of urinary incontinence being experienced.   This simple non invasive test can be performed in any setting, but does need to be administered by somebody with knowledge of the test.

Anorectal Manometry

The purpose of anorectal amnometry is to assess anorectal function (including sphincter pressures).  In order to assess this function, rectal pressure is recorded via a fine catheter. When anorectal function is known then an accurate diagnosis of bowel dysfunction can be made.

Anorectal manometry is an invasive investigation, which requires a sophisticated machine and a specialist to administer the test and interperate the results.  For these reasons, this investigation is only available at GRH or CGH.   

Anorectal Ultrasound

This investigation is available via the Ultrasound Departments at both GRH and CGH and is used in the assessment of bowel dysfunction, particularly when anal sphincter damage is suspected.

Further information or advice regarding specialist continence investigations can be obtained from Gloucestershire Continence Service.