Do I really need a urodynamic test?

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Hi folks

I suspended my BCG therapy at dose number 15 because of LUTS (lower urinary tract symptoms), specifically - pain/discomfort when urinating and associated urgency and frequency. This has been going on for months. The pain is intermittent but when it happens i need a tramadol and a lie down with a hot water bottle. I need to take a pee 5-10 times a night, so not much quality sleep.

My urologist is proposing urodynamic tests to investigate it but I’m not happy about this. I believe the intravesical treatments (i.e., a tube inserted into the urethra – hope I got the terminology right) are partly responsible for my symptoms. I think this because the symptoms were slowly calming down and then I had a cystoscopy (no BCG involved) and it sparked off the symptoms again, back to square one. I know that if I want to save my bladder, I will need to undergo cystoscopies, but urodynamic testing? I can see that measuring bladder capacity, flow rate, trigger point for the afferent nerves and so on provides potentially useful data, but I don’t understand how it can be used to diagnose a specific condition or help me to manage my symptoms. I’d rather try different medications to see which, if any, works and explore changes to my lifestyle, diet and exercises to see what helps. I can’t discuss this properly with my urologist because I’m a Brit living in France with poor French and besides, the urology unit is in a small hospital and he’s the only urologist there and he is incredibly busy. I’m lucky if I get a rushed 5 minutes with him in a meeting, and I don’t get many meetings. I’d be grateful for your thoughts.

Cheers,

Mike

  • Hi  . Sorry to hear you are still in a lot of discomfort. Not had these tests myself, but I can understand your reluctance to go ahead with further invasive procedures. I suppose it comes to weighing up what the long term benefits will be. Hopefully someone who has been through this will be along to let you know what the outcome was. Best wishes. 

    Best wishes to All,   rily.

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  • Hi Mike,Urodynamics can be useful,I expect your uro wants a better understanding of how your urinary tract is working.I’ve had them before and they were able to rule out an obstruction.I then had further tests and a biopsy which showed I had Interstitial cystitis.This came after many years of pain,urgency and frequency and being fobbed off by many dr’s.The damage from frequent infections and irritation led to bladder cancer.Best wishes whatever you decide.Jane x

  • Hi Jane, what test did they use to diagnose interstitial cystitis?

  • Hi,At the first cystoscopy they found bladder ulcers and I was diagnosed by biopsies 12 years later.I used to have ulcers and red patches burnt away quite often.Eventually the whole bladder was covered in scales which were pre cancerous.I was on cancer surveillance for 14 years before developing Squamous cell cancer.I had bladder removal in 2019.Jane x