Pain and embarrassment associated with urodynamic testing in women

• Published in: International Urogynecology Journal 2014-05, Vol.25 (5), p.645-650
• Main Authors: Yeung, Jennifer Y., Eschenbacher, Michaela A., Pauls, Rachel N.
• Format: Article
• Language: English
• Subjects: Anxiety - etiology; Cystitis, Interstitial - diagnosis; Cystitis, Interstitial - physiopathology; Diagnostic Techniques, Urological - adverse effects; Female; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pain - etiology; Patient Satisfaction; Prospective Studies; Shame; Surveys and Questionnaires; Urinary Bladder, Overactive - diagnosis; Urinary Bladder, Overactive - physiopathology; Urodynamics; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-013-2261-1

Introduction Multichannel urodynamics is a series of interactive tests used to evaluate lower urinary tract dysfunction. We sought to describe symptoms and satisfaction in a cohort of women undergoing these procedures. Methods Females undergoing urodynamics completed questionnaires immediately (Q1) and 1 week (Q2) after their testing. Surveys utilized visual analog scales (VAS) from 0 to 10 to assess pain, embarrassment, anxiety, and satisfaction. Q2 also inquired about urinary symptoms in the days following the procedure. Results 100 women were analyzed. Regarding symptoms on the day of testing, VAS scores indicated low bother; with a median of 1.5/10 for pain, 0.4/10 for embarrassment, and 1.8/10 for anxiety. One week following, recall of pain ( p  = 0.169), and embarrassment ( p  = 0.722) were similar. Further analyses suggested that overactive bladder syndrome (OAB) might be associated with greater pain during and after the procedure ( p  = 0.04, p  = 0.038 respectively), while depression was associated with greater embarrassment at those times ( p  = 0.018, p  = 0.027 respectively). Painful bladder syndrome (PBS) was associated with a higher recall of pain ( p  = 0.018), and anxiety with more embarrassment ( p  = 0.033) on the second survey. Finally, younger age correlated with higher pain on both questionnaires (Q1: τ = − 0.148, p  = 0.029; Q2: τ = − 0.171, p  = 0.014). Following urodynamics, urgency was most common (43 %), generally resolving within 1 day. Reassuringly, 86 % would repeat urodynamics if necessary, and overall satisfaction was rated ≥9/10 at both time points. Conclusion Urodynamic testing is well-tolerated in women. Nevertheless, younger age, anxiety or depression, and a diagnosis of OAB and PBS may lead to more negative experiences. Such information may be useful in counseling future patients.