Ward urodynamics

A ward urodynamics test is a specialised type of test that measures the pressure inside your child’s bladder. 

It may be suggested if your child is having trouble staying dry (continent) or has other problems weeing (urination). It may also be suggested if your child has structural problems with their urinary system. Saline (salt water solution) is inserted into your child’s bladder while the pressure inside the bladder is measured.

Various types of scan such as ultrasound and x-rays can show the size and shape of your child’s urinary system but not how it is working. The results of the scan are used to plan your child’s treatment.

If you are unable to keep this appointment, please inform the department at least two weeks beforehand. Sometimes, we can offer the appointment to another child on the waiting list.

We will send a 48-hour measuring chart to record how much fluid your child drinks and how much they wee in a two-day period. Please remember to bring this with you to the appointment as we may have to reschedule the test if we do not have this vital information.

Please note: if your child already has a Mitrofanoff or supra pubic catheter in place, this will be used rather than insert two catheters as described below. It may also be performed using a catheter inserted through the urethra.

A day or two before the scan is scheduled, your child will need to come to Great Ormond Street Hospital (GOSH) for a short procedure with a general anaesthetic to insert two catheters (thin plastic tubes) through the skin into their bladder. Your child’s doctor will explain the operation in more detail, discuss any worries you may have and ask your permission for the operation by asking you to sign a consent form. An anaesthetist will also visit you to explain about the anaesthetic in more detail and options for pain relief afterwards. If your child has any medical problems, please tell the doctors about these.

After the procedure, your child will come back to the ward to recover from the anaesthetic and can go home or to the Patient Hotel when they feel well enough. The two catheters will be coiled up next to your child’s skin and covered with a dressing. Your child should keep this dressing clean and dry until the scan so a wash with a flannel is preferable to a shower or bath. Your child may feel a bit uncomfortable after this procedure but paracetamol or ibuprofen should be strong enough to deal with any discomfort. Drinking plenty of fluid after the procedure can also help.

Please arrive at the Urodynamics Unit at the time stated in your child’s appointment letter. The nurses will check that your child has recovered from the procedure to insert the catheters and is fit and well for the test.

You will be able to stay with your child throughout the test. The nurse will insert a catheter into your child’s rectum (bottom). The catheter is very small and we use lubricant jelly so this is not painful but may be a little uncomfortable. This catheter measures the pressure inside your child’s abdomen during the test.

They will then remove the dressing covering the two catheters and flush them with water to make sure they are working correctly.

One of the catheters will be connected to a computer to measure the pressure inside the bladder and saline is dripped through the other catheter into your child’s bladder. While the bladder is filling with saline, the the nurses will measure the pressure inside the bladder.

At the end of the test, the nurses will snip the tiny stitches holding the two catheters in place, remove them gently and cover the area with a fresh dressing. They will also remove the catheter from your child’s bottom. The test usually takes about an hour.

There is a risk of infection from the catheters inserted into your child’s bladder, so we will give your child a five day course of antibiotics to take at home. Please make sure that they complete the entire course.

If they are not having any further tests or scans, you will be free to go home.

You should call the Urodynamics Unit or your family doctor (GP) if:

• Your child is in a lot of pain and pain relief does not seem to help
• The wound site looks red, inflamed and feels hotter than the surrounding skin
• There is any oozing from the wound 
• Your child has a lot of blood in his or her urine
• Your child develops a high temperature 

The team will have a meeting after the test to discuss the results and plan your child’s treatment. We will then offer an appointment in the Outpatients department, Urodynamics department or over the telephone to discuss next steps.