Urinary incontinence characterized (eg, frequency, volume, timing, type of symptoms, how bothersome) (GER)
CPT4 code
Name of the Procedure:
Urinary Incontinence Characterization (GER)
Common name: Urodynamic Testing
Technical terms: Uroflowmetry, Postvoid Residual Measurement, Cystometry, and Pressure Flow Studies
Summary
Urinary Incontinence Characterization is a series of tests used to assess bladder function by measuring various aspects such as frequency, volume, timing, type of symptoms, and how bothersome they are. It helps in diagnosing the type and severity of urinary incontinence.
Purpose
The procedure addresses urinary incontinence, which is the involuntary leakage of urine. The goal is to diagnose the type of incontinence and understand its impact on the patient's quality of life, to guide appropriate treatment.
Indications
- Frequent urination
- Unexpected urine leakage
- Difficulty emptying the bladder completely
- Uncontrollable urges to urinate
- Painful urination This procedure is appropriate for patients experiencing symptoms of urinary incontinence that are affecting their daily life.
Preparation
- The patient may need to arrive with a full bladder.
- Avoid caffeine and alcohol before the test.
- Medication adjustments may be required as advised by the healthcare provider.
- A preliminary evaluation, like a bladder diary or urine analysis, may be conducted beforehand.
Procedure Description
- Uroflowmetry: The patient urinates into a special device that measures the flow rate and volume of urine.
- Postvoid Residual: A catheter or ultrasound is used to measure the amount of urine left in the bladder after urination.
- Cystometry: A catheter is inserted into the bladder to measure its capacity and pressure during filling and storage.
- Pressure Flow Study: Assesses the pressure required to urinate and the flow rate to identify any blockages or abnormal bladder activity. These tests usually do not require anesthesia, but mild sedation may be given if the patient is particularly anxious.
Duration
The entire procedure typically lasts 30 to 60 minutes.
Setting
The tests are usually performed in an outpatient clinic, urologist's office, or specialized diagnostic center.
Personnel
- Urologist
- Nurse or Urology Technician
Risks and Complications
- Mild discomfort or pain during catheter insertion
- Risk of urinary tract infection (UTI)
- Rarely, hematuria (blood in urine) or urethral injury
Benefits
- Accurate diagnosis of the type and severity of urinary incontinence
- Facilitates tailored treatment plans, which can improve symptoms significantly
- Provides detailed information for surgical planning if needed
Recovery
- Patients can typically resume normal activities immediately.
- Drink plenty of water to help flush out the bladder.
- Report any signs of infection (e.g., fever, increased pain).
- A follow-up appointment may be scheduled to discuss test results and treatment options.
Alternatives
- Bladder diary and symptom questionnaire
- Basic urine flow and postvoid residual measurement without full urodynamic testing
- Empirical treatment based on symptoms alone
Patient Experience
During the procedure, the patient might feel some discomfort due to catheter insertion and bladder filling but it is generally well-tolerated. Mild pain management and comfort measures, such as topical numbing gel or sedatives, can be used to minimize discomfort.