What is a video urodynamics study (VUDS)?
A VUDS is a test done by your child’s doctor that provides information about how well your child’s bladder is working. It combines two procedures: one that measures your child’s bladder storage ability and how well it fills and empties (cystometry), and one that takes X-ray images of your child’s bladder (cystography).
A VUDS measures:
- What is happening to your child’s bladder as it is filling and emptying
- How much urine the bladder can hold and its ability to empty completely
- Bladder sensation (feeling)
- Changes in bladder pressure
X-rays of the bladder are also taken during a VUDS to visualize what is happening inside it during the test.
The information on this page will help you and your child get ready for the procedure. After reading it, please explain it to your child using words they can understand. If you have questions, please speak with your child’s doctor or a member of the urodynamics team.
Your child's appointment
Please arrive 30 minutes before the time of your child’s appointment. The procedure usually takes between 1.5 to 2 hours.
Helping your child get ready for the test
The VUDS will be easier and less uncomfortable if your child is relaxed. Before you come to the hospital, explain to your child what will happen. You can help practice relaxing by having your child breath in and out with slow deep breaths.
To make your child feel more comfortable during the test, bring their favourite toy, a movie, tablet, music or books. Child life specialists can help your child get ready for the test by teaching them to relax and distract themselves. If you think your child would benefit from working with a child life specialist, please reach out to the urodynamics team prior to your appointment. A visual storyboard to help prepare your child for the VUDS is also available on request. A few days before the procedure, your child may be required to do a bowel prep with suppositories (medication that is inserted into the rectum). This will clear out your child’s bowels and help with getting accurate results during the VUDS. If your child is constipated, they may require stool softeners.
Before the test
Please make sure that your child has something to eat and drink a few hours before the VUDS.
If possible, encourage your child to try to have a bowel movement on the morning of the test.
If your child has a heart condition, please check with your family doctor to see if your child will need antibiotics before the test. If antibiotics are needed, your family doctor will write a prescription.
Please do not use lotion or cream on your child’s skin on the day of the test.
Urinary tract infection
Please be aware that the test will not be done if your child has a urinary tract infection and is showing symptoms. Signs and symptoms of a urinary tract infection include:
- Burning or stinging with urination
- Foul smelling or cloudy urine
- Abdominal (belly) pain
- Fever
- Blood in the urine
If your child has any of these symptoms, please go to your family doctor to check for a urinary tract infection. If your child has an infection, please call to reschedule your appointment.
Who will be present for the test?
A VUDS is conducted by the urodynamics team at the hospital. Your child’s urodynamics team will include a:
- urology nurse practitioner
- medical radiation technologist – voiding cystourethrogram (VCUG) specialist
You may also be present for the test. One parent/caregiver is allowed to stay with your child during the procedure. You will be required to wear a lead apron to protect yourself from X-rays.
What happens during the test?
On arrival to the GI/GU department, after check-in, your child will be asked to go to the washroom to empty the bladder and put on a hospital gown. A technologist will start the VUDS by getting to know your child and taking a complete health history. To begin the procedure, the technologist will put a small tube called a urinary catheter into your child’s urethra (urinary passage). If your child catheterizes the bladder at home through a stoma, the test may be also done through this passage. Your child’s bladder will be filled with X-ray contrast agent through this tube. This tube also monitors pressures in the bladder.
Another small tube will be put into your child’s rectum. This tube measures abdominal pressure during the test. The rectum pushes on the bladder, and this can affect bladder pressure. If your child catheterizes the bowel at home through a stoma, the test may also be done through this passage.
Your child will also have stickers called electrodes gently stuck to the buttocks and knee. The electrodes let the technologist assess your child’s pelvic floor muscles when the bladder is being filled.
The technologist will be taking X-ray images throughout the study to watch the bladder and urethra during filling and emptying.
Your child’s comfort
Having these tubes inserted can be uncomfortable, but it should not hurt. The technologist is very experienced and will help your child relax during the test.
During the test, your child may have a feeling of fullness or pressure, similar to what they would feel before urinating with a full bladder. The technologist will encourage your child to let them know when your child is having these sensations during the test. This will help the technologist understand how your child’s bladder is working.
There may be some discomfort when the urinary and rectal tubes are put in and taken out. Your child may have the urge to urinate or have a bowel movement. These feelings will decrease if your child is more relaxed. You or the child life specialist can help your child with the relaxation strategies you practiced.
Sedation
Some children may need mild sedation or topical anaesthetic, to help them relax and have a positive experience during the test. Please ensure to talk to the urodynamics team at the time of booking to see if sedation or topical anesthetic is an option for your child.
After the test
Your child may feel stinging or burning when urinating the first few times after the test. Encourage your child to drink a lot of fluids after the test. If the discomfort lasts for more than 48 hours (two days) or your child develops a fever, contact your family doctor.
At SickKids
The VUDS will be performed in the GI/GU department of the hospital, which is on the 2nd floor of Burton Wing. Please arrive 30 minutes prior to your child’s appointment to ensure enough time for parking, complete screening, registration and check in.
If you have any questions or concerns about this test, please contact the urology clinic at 416-813-7654 ex.206661 or email urology.clinic@sickkids.ca to connect with someone from the urology team.