Back from urodynamics testing...DSD?

[humpieumpumkin]

I just got back from urodynamics. My bladder showed normal compliance during filling(although my capacity is low) but During voiding I showed a "stacatto" pattern and this is not good. My bladder and urethral sphincter dont communicate correctly I guess. Does anyone know what this means? I only saw a nurse today. She said it wasn't normal. The image on the computer showed an up and down pattern during voiding that resembled a EKG when they monitor your heart. I'm concerned and I don't really know what this means or is. Any information would be great! Thanks!

Erika

[Cardholic]

I pulled this off of this web page http://www.medscape.com/viewarticle/546017_3 ... "Staccato voiding is characterized by bursts of pelvic floor activity during voiding, which leads to a rhythmic voiding pattern with incomplete bladder emptying and prolonged urinary flow."

I have no idea if this is correct... hope it helps

[tigger_gal]

thats what I was going to say too. bladder spasms during a void, it may not be normal for a normal bladder, but be normal for and ic bladder. Did she give an idea what your bladder held?

[ICNDonna]

Bladder spasms is one possibility.

Donna

[jen74]

Hi Erika.
I am not sure what all that means, but I am glad you made through ok. Was the test real bad, or painful? I will likely end up having to do this test at some point also I am afraid.
The only bad thing is, I will not be able to pee with someone in the room or even knowing someone is waiting for me. I am a very shy pee'er I was going to do this test a while back, but after the doc told me that I would have to pee infront of a nurse and with a cath inside me, I just forget it, it is not going to happen. And I did not want to go through a test that was very expensive that I could not even complete and would likely not get great results if I could not complete it.
But I think I may eventually have to go through it. Maybe they will just have to skip the peeing part for me, I dont know.
Anyhow, I am glad you made it through and hope you get some answers.
Jen

[Sarojini]

I had the same thing upon voiding when I had a urodynamics testing -- usually that pattern means either bladder spasms, pelvic floor spasms, straining to void, or a combination of all of these. So yes, the bladder muscle, sphincter muscle, and pelvic floor muscles are all working out of sync. This is common in ICers and those with PFD.

It's absolutely not the worst thing you could have found out, especially since your bladder filling was pretty normal.

My doc's first line of treatment for that staccato pattern is pelvic floor physical therapy -- to try to teach those muscles to communicate properly again.

[petrie86]

Hey Erika!!! That test is new to me. I havent heard of that before but maybe have your real uro take a look at the results of the test so he can pinpoint the exact problem. I'm glad they found it out... always think things could always be worse. I know it stinks. Do they have meds to help control the flow of urine or the spasms?? I hope your doing ok!!! Sending you huggs. Did your boss give you a hard time about going for testing??

Rach

[verdicries]

i had the same problem (and i had the test done TWICE...UGH), although 2 doctors SWORE up and down that my bladder/urethra WEREN'T spasming (my current urogyn got my results and assured me, yes they are. i'm not nuts!). i have severe spasming and incomplete emptying...i saw the computer screen and it was all over the place!! you're definitely not alone.

[humpieumpumkin]

Thanks guys! The test for me was moderatly painful. THis is uncommon. I do think the IC made things worse. They gave me prosed samples once the test was over along with an antibiotic. I felt fine once the blue pee thing started. I'm concerned mostly becuase physical therapy has proved to be a waste of time and money for me(almost been a month now since I started.) Although for some it is a miracle! The exercises I do at home make me sore, and I still can't relax my pelvic floor on command. I'm doomed. Oh well.

Erika

[ICNDonna]

One month of physical therapy isn't usually enough to make much difference.

Donna

[humpieumpumkin]

Good. At least I still have hope Donna! I don't know if I am still a canadate for interstim anymore, although the nurse did mention that occasionally he did use them for voiding problems despite limited bladder contractions on filling. My awake capacity is about 300mls-and yes I waited alot longer than I would have if I ws home. I let the nurse know that. I was standing in an absorbent pad with no undies, so I wasn't scared to pee myself! HAHA! My question is, to anyone who has the interstim(Jen 'im thinking of you in particular) did the procedure help you pee more normally? I just wonder if the surgery would be unnessacary now. I do know that it is approved for dsd under the billing codes. How long should give the pt before I look into more invasive treatment? I'm thinking like 3 months, is that reasonable? Thanks for your help.

Erika

[Sarojini]

Hi... it's me

My voiding was quite abnormal on urodynamics testing; in fact, if it's possible to fail that test, I did! My bladder capacity was something like 237 cc and that was also waiting way longer than I should have.

Anyway, after the test, since I'd had PT in the past for months on end, my doc presented the InterStim as an option, but didn't force it on me. After several months of thinking, I went for it... and lo and behold, I pee more normally!

While I've not had a urodynamics test post-op, I do know that I can hold it much longer (frequency is down to 6-12 times a day from 25-35) and when I do go, the "staccato" pattern has mostly disappeared. I get it occasionally during my first morning urination because my bladder is angry and spasming from holding urine all night (I don't get up in the night anymore), but the rest of the time I sit down and pee with a much stronger, continuous stream.

Definitely wait until you have an appointment with your doctor to discuss what your urodynamic results mean -- he will explain what he thinks is going on, present his recommendations, and the two of you should go from there. It's possible he may still recommend the InterStim, but possibly not. There are a lot of factors they look at during that testing that the nurse didn't discuss with you, so it will be interesting to see what the doc's conclusions are

However, a urodynamic study is pretty much required with a lot of insurance companies before they will pay for the Stim these days, so at least you have that over and done with in case you do decide to go that route.

[humpieumpumkin]

Hahaha! Its so funny you said that Jen! My uro, who is God BTW told me that if I wanted ins. to pay for the procedure, I HAD to have the testing or they wouldn't even consider. I was scared by the results, becuase they could indicate a more seriuos neurological condition. I'm happy the stim works for the voiding problem too. :woohoo: I am however, not sure if that option is still offered at the next visit I would still consider it until I have more pt. Like donna said, 4 weeks isn't enough to notice a difference. I do know that the nurse said my pressures on voiding WERE high enough to cause permanent kidney damage and reflux. That makes me wonder if sooner treatment is better than waiting. Well I do seem to be in a bit of a pickle here. I can't wait for my appt! The nurse said he would go over the results with a magnifiying glass! I know him and he will too! Well thanks for your prompt response Jen! And for everyone else who is helping me with the decision I have here. I will update you all next Wed. after I sit down with my Uro about the results. Thanks agian everyone!

Erika

[**Angie**]

I had a hard time with PT but it did help when I figured out what muscles to let go. I've even had to go back for a refresher. Try to stick out a little longer or if that doesn't help maybe you need another PT??