Treatments — Functional Urology
Urodynamic Assessment — Bladder Function Testing
The gold standard diagnostic test for bladder and urinary problems. Urodynamics objectively measures how your bladder stores and releases urine — providing the precise diagnosis needed to guide truly effective treatment.
Why Urodynamics Changes Everything
Identifies the exact cause of your bladder symptoms — not just guesswork
Essential before any surgical treatment for incontinence or bladder problems
Performed and interpreted by Mr. Jesuraj himself — results discussed same day
Explains why previous treatments haven’t worked — and what will
The Investigation
What Is Urodynamic Testing?
Urodynamics is a series of tests that assess how the bladder, urethra, and surrounding muscles perform during filling and voiding. Unlike an ultrasound or cystoscopy — which look at anatomy — urodynamics assesses function. It tells us what your bladder actually does, not just what it looks like.
Many patients come to Mr. Jesuraj having seen multiple clinicians and tried multiple treatments without success. In a significant number of these cases, the treatment they received was based on symptoms alone — without the objective data that urodynamics provides. The result is often years of ineffective treatment.
Urodynamics changes this. It provides a precise, objective, reproducible measurement of bladder behaviour — enabling targeted treatment that works.
Who Should Have Urodynamics?
- Women with urinary incontinence — to determine type and cause
- Men or women with overactive bladder not responding to medication
- Anyone with mixed incontinence (stress + urge)
- Patients with difficulty emptying the bladder
- Before any surgical treatment for incontinence
- Neurological conditions affecting bladder control
- Recurrent UTIs with voiding difficulties
- Previous bladder or pelvic surgery with ongoing symptoms
- Men with urinary symptoms where cause is unclear
The Tests
What Does Urodynamic Testing Involve?
A urodynamic study involves a series of individual tests — each measuring a different aspect of bladder function. The full study typically takes 45–60 minutes. Mr. Jesuraj supervises the study throughout.
Uroflowmetry
The simplest and most comfortable test. You urinate into a special funnel that measures the rate and volume of urine flow. A normal flow curve is bell-shaped — abnormal patterns indicate obstruction, poor detrusor contraction, or straining.
Post-Void Residual (PVR)
Immediately after urination, a quick bladder ultrasound measures how much urine remains. Significant residual urine indicates incomplete emptying — a common cause of recurrent infections, overflow incontinence and urinary symptoms.
Cystometry (Filling Phase)
A fine catheter measures bladder pressure as it is slowly filled with sterile water. This identifies detrusor overactivity (involuntary bladder contractions), poor bladder compliance, and the volume at which symptoms occur. This is the key test for diagnosing overactive bladder.
Pressure-Flow Study (Voiding Phase)
Simultaneously measures bladder pressure and urine flow rate during voiding. This is the key test to differentiate bladder outlet obstruction (e.g. from prostate enlargement or urethral stricture) from detrusor underactivity (weak bladder muscle) — conditions that look identical on uroflowmetry but require completely different treatment.
Urethral Pressure Profile
Measures the pressure along the length of the urethra — assessing urethral sphincter function. Particularly useful in women with stress incontinence to assess sphincter competence before surgical treatment.
Electromyography (EMG)
Where neurological bladder dysfunction is suspected, EMG measures electrical activity in the pelvic floor muscles — assessing coordination between the bladder and sphincter (dyssynergia), which occurs in neurological conditions including MS and spinal cord disease.
What We Find
Conditions Diagnosed by Urodynamics
Urodynamics provides objective confirmation of these conditions — enabling precisely targeted treatment.
Involuntary bladder muscle contractions — the underlying cause of overactive bladder and urge incontinence.
Urethral sphincter weakness causing leakage with physical activity — confirmed on cystometry with stress manoeuvres.
Elevated voiding pressure with poor flow — in men usually due to BPH, in women due to prolapse or urethral narrowing.
Poor bladder contraction causing incomplete emptying — differentiated from obstruction only by pressure-flow study.
Bladder dysfunction caused by neurological disease — characterised by specific urodynamic patterns guiding safe management.
Coexisting stress and urge incontinence — urodynamics determines which is predominant and guides treatment priority.
Your Experience
What to Expect on the Day
Preparation
Attend with a comfortably full bladder. Bring a completed bladder diary if you have been asked to keep one. Continue all regular medications unless specifically advised otherwise. Wear comfortable, easy-to-remove clothing.
The Study
A trained nurse assists with catheter placement. The tests are conducted sequentially — Mr. Jesuraj is present throughout and monitors the traces in real time. You will be asked to report symptoms as they occur — this information is critical to interpretation.
Same-Day Results
Mr. Jesuraj reviews the traces with you immediately after the study — not at a follow-up appointment weeks later. You will leave with a clear explanation of what has been found and what it means for your treatment.
Treatment Plan
A written report is prepared. Treatment is selected based on your specific urodynamic findings — whether that is medication, physiotherapy referral, further investigation or a surgical procedure.
⚠️ A note on comfort: Urodynamic testing involves catheterisation, which some patients find uncomfortable. It is not painful. The clinical team maintains your dignity and comfort throughout. Most patients find the investigation far less daunting than anticipated.
Full Urodynamic Study
£650
Includes
- Uroflowmetry
- Post-void residual ultrasound
- Cystometry (filling phase)
- Pressure-flow study (voiding phase)
- Additional tests as clinically indicated
- Immediate results review with Mr. Jesuraj
- Written urodynamic report
- Treatment plan and follow-up advice
Insurance
Urodynamics is covered by most major health insurers. Always check with your insurer before the appointment and obtain a pre-authorisation number.
BUPA · AXA PPP · Vitality · Aviva · Cigna
Self-funding patients are always welcome — payment is taken on the day.
Get the Right Diagnosis — Finally
Appointments at Best Life Clinic, Stockton-on-Tees — Monday, Thursday and Friday. Most patients seen within 7 days. No GP referral required.