Your urinary and reproductive systems are affected by the proper functioning of the nervous system. If you have Parkinson’s disease, stroke or spinal cord injury, the nerves which control your bladder and reproductive functioning may be affected.

Neurogenic bladder disorder, erectile dysfunction, and Peyronie’s disease are urological conditions which can be caused by neurological dysfunction. If you suffer from these or other related conditions, a urologist who specializes in neurourology can help.

Diagnosing Urinary Problems: Urodynamic Studies

Neurourology is the study and practice of treating complex lower urinary tract conditions and reproductive functioning affected by the nervous system. Neurourologists use a comprehensive set of tests known as urodynamic studies to get a detailed understanding of how your bladder, sphincter and urethra are working. Urodynamic studies will help your neurourologist determine the best course of treatment for your urinary tract issues.

Types of Urodynamic Tests

Your doctor may perform one of these tests depending on which is most suited to your situation.

Uroflowmetry test uses a uroflowmeter device which measures the amount of urine, the rate of urine release, and the amount of time it takes to reach peak urine flow. this can determine the strength of your bladder muscles.

Multi-channel video testing uses x-rays or sound waves to take pictures of your lower urinary tract while your bladder fills and empties.

Cystometrogram (CMG) testing makes use of two catheters. One is inserted into the bladder to fill and empty your bladder with warm fluid, and the other is inserted into the vagina or rectum to gauge the pressure your bladder experiences when it is full.

Pressure study also gauges the effects of abdominal pressure. While often done in conjunction with CMG, pressure studies are especially effective in diagnosing stress incontinence.

Electromyogram is commonly done with CMG and measures bladder muscle signals. Abnormalities in bladder muscle signals can also result in urinary dysfunction.

Voiding cystourethrogram uses x-ray images of the lower urinary tract when the bladder is filled and emptied of a fluid containing contrast-dye to determine if there are obstructions affecting urine flow.Post-void residual test is performed using an ultrasound or a catheter inserted into the bladder to see if your bladder retains residual urine after voiding.

What to Expect During Urodynamic Testing

When you go in for a urodynamic test:

• Your urologist will instruct you to arrive for urodynamic testing with a full bladder.
• You will be taken to a private room where you will empty your bladder into a receptacle which measures urine output.
• After urination, your doctor will have you recline in a chair with stirrups so that a thin catheter can be inserted through your urethra into your bladder. Most patients find this catheterization to be merely uncomfortable, not painful.
• The catheter will be used to fill your bladder with sterile saline solution. This will help evaluate how well your bladder fills, retains, and voids urine. You may be asked to urinate again either with or without the catheter.

Reproductive issues treated by a neurourologist

In addition to urogenetic studies, a urologist specializing in neurourology will specialize in treating reproductive issues caused by neurological dysfunction.

Erectile dysfunction (ED) and Peyronie’s disease are examples of sexual disorders which may be affected by the nervous system. Your doctor will be well versed in issues which may lead to these conditions, such MS, spinal cord injuries, tumors or injuries affecting the brain or spinal cord, or illnesses such as stroke, Alzheimer’s, or Parkinson’s.

Congenital conditions like spina bifida or cerebral palsy may also contribute to reproductive problems. A neurourologist can help treat ED with medications, external devises or surgery. Peyronie’s disease treatment is still considered experimental in nature, but medication and surgery are among treatment options available.

Consult with your urologist if your urinary and reproductive issues are related to neurological issues.