First Urodynamics Study

For all the years that I have been living with spinal cord and chronic renal failure, I have not had a urodynamics study done to determine the pressure in my bladder. This test is needed to determine whether the pressure in the bladder will cause a reflux and further damage to the kidneys.

I had one done at SJMC last Saturday for once and for all as to see if the pressure in my bladder is the cause of my renal failure and whether I need further treatment. I have been waiting to get it done at UMMC but two appointments were cancelled. The first time was because the urologist was away and the second because the urodynamics clinic was under renovation.

All garbed up at SJMC waiting for the urodynamics study to commence
All garbed up at SJMC waiting for the urodynamics study to commence.
Photo by Wuan.

There is usually a six-month waiting period at UMMC but it would have been done free of charge there as I hold the Kad Orang Kurang Upaya from the Department of Social Welfare Malaysia. It costs RM1,500 at SJMC. Another urodynamics study was schduled for mid-June at UMMC but I thought I better get it done first at SJMC just in case the one at UMMC gets cancelled again.

The procedure was not as embarrassing as I had anticipated. The technician was very patient in explaining the entire procedure and made me feel at ease even though I was bare-bottomed throughout. A thin tube was inserted through the urethra into the bladder and another into the rectum. The tubes were connected to a device that fills up the bladder with saline at a pre-determined rates – 30ml/min and 15ml/min, measured the pressure in the bladder as it filled up until urine started to leak.

The equipment used for the urodynamics study
The equipment used for the urodynamics study.
Photo by Wuan.

Another device was placed right below my seat to measure the amount of urine that leaked. After that, the residual urine in the bladder was sucked out with a syringe and measured. The results showed that the presurre in my bladder is normal until the volume is around 300ml where the pressure rises to slightly more than 50cmH2O and the fluid started to leak. The leaked volume was around 100ml while residual volume was around 200ml.

According to the urologist, as long as I keep up with my three hourly intermittent catheterisation programme, it should not be a cause for concern as reflected by the results. No further treatment or medication is necessary. He recommended that I get the urodynamics study done every two years. He also checked the lump in my scrotum which has gotten smaller after a two-week course of antibiotics. I am to go back to see him in two months to get the lump checked again.

What I Did Yesterday

Woke up extra early and went to SJMC to consult a hematologist regarding my anemia. I have been breathless and feeling lethargic for a while now. It is no fun waking up after 12 hours of sleep feeling like I need another 12 hours more. At the same time, had the lump in the scrotum checked by a urologist. Apparently it is an infection of the epididymis caused by constant catheterisation. I am on a 2-week dose of Zinnat, an antibiotic, that hopefully will clear up the lump by then. He also scheduled me for a urodynamic testing to check on the pressure in my bladder.

In the 24 years since my spinal cord injury, I have never undergone any. UMMC had scheduled to urodynamic tests but both we called off – once because the doctor was away and the other because the lab was being renovated. These appointments are usually scheduled 6 months prior. Although the procedure is done free of charge at UMMC and costs RM1,500 at UMMC, I decided that I wanted to know if the pressure in my bladder is the cause of my renal failure and what can be done to prevent further damage.

After that, Wuan and I went all the way to the Palace of Golden Horse at Seri Kembangan for a buffet lunch with some good friends. One will be leaving Malaysia with his family in July. And then we drove all the way back to Damansara Mutiara for a meeting with the good people from the Malaysia Association of Standards Users at The Curve. We talked about the standards of accessibility which, although in existence since the last decade, are seldom adhered to by the local governments.

To sum it all up, I had to pull down my pants twice to have my testicles examined, drove all over Kuala Lumpur and Selangor to meet friends and make new friends, were extremely late for both appointments, and came back all fired up for no apparent reason and only fell asleep at 3am. It had been a tiring day but worth the effort.

I also have this one thing to say about SJMC. Although it is a hospital, there were no accessible parkings and I was made to circle the buildings twice before I found an empty standard-sized lot near to the entrance. The hospital management should really take note of this. They should not expect wheelchair users to park their cars at the open space which is a long distance from the entrance and down a steep slope. Of all places, I expect hospitals to be the most accessible place but this seldom the case. That is one of the reasons why I dislike going to hospitals.