Because hormone levels and muscle tone change with age, stress incontinence (leakage of urine while coughing, laughing or during exercise or lifting) can become a problem for anyone in middle age. Carolinas HealthCare System's medical professionals use urodynamic tests to pinpoint the cause of the problem and develop solutions which are often nonsurgical.

Urodynamic Testing
Urodynamics refers to a series of diagnostic tests that evaluate the function of the bladder and urethra. These tests may be recommended if the patient has urinary incontinence (leakage of urine), recurrent bladder infections, slow or weak urinary stream, incomplete bladder emptying or frequent urination. These tests provide important information for the physician to accurately diagnose and treat a patient's bladder problem.

Urodynamic tests include:

• Uroflow - This test measures the amount and speed of urine that is voided.
• Cystometrogram - This study evaluates how the bladder holds urine, measures the bladder capacity, and also determines how well the patient can control their bladder.
• EMG - This test measures how well a patient can control the sphincter (outlet) muscles and determines if they are working in coordination with the bladder.
• Pressure Flow Study - This test determines if there is an obstruction.
• Videourodynamics - This study is a combination of the above tests, with the addition of video pictures. A physician and a registered nurse are present to explain each step of the process and the most effective treatment.
• Biofeedback/Pelvic Floor Muscle Exercise Therapy - This nonsurgical therapy is used to treat incontinence. Typically, this therapy consists of weekly sessions for six weeks.

The following Carolinas HealthCare facilities provide urology and continence services:

Charlotte Continence Center
Charlotte Continence Center on the Carolinas Rehabilitation campus in Charlotte, N.C., provides comprehensive urological services. Patients are referred by their physicians for urodynamic studies and/or the treatment of bladder dysfunction. Patients without a physician's referral can be seen by one of the urology nurses for assessment and assistance with urinary incontinence.

McKay Urology
McKay Urology, located in Charlotte, N.C., is a subspecialty urology practice. Its staff includes physicians specializing in neurourology, incontinence, female urology, male infertility, and metabolism disorders such as kidney stones. All physicians are board certified by the American Board of Urology.

The Women's Institute at Carolinas Medical Center
Whether their disorders are annoying and embarrassing or potentially life-threatening, women with complex gynecologic problems deserve the best diagnostic and therapeutic care available. That care is available at The Women's Institute's Center for Gynecology in Charlotte, N.C. It specializes in gynecologic surgery, gynecologic dermatology and urogynecology.