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Home uroflowmetry for the evaluation of boys with urinary incontinence
Stephen Shei Den Yang1, Chung Cheng Wang, Yung Tai Chen
1Department of Urology, En Chu Kong Hospital, School of Medicine, Taipei Medical University, Taiwan.
Insights
Home uroflowmetry effectively identifies abnormal voiding in boys with urinary incontinence. Abnormal results frequently indicate bladder outlet obstruction or detrusor overactivity, correlating with videourodynamics.
Area of Science:
- Pediatric Urology
- Urodynamics
- Voiding Dysfunction
Background:
- Urinary incontinence in boys requires accurate diagnostic methods.
- Home uroflowmetry offers a patient-friendly alternative to in-clinic assessments.
- Correlation with videourodynamics is crucial for validating home-based measurements.
Purpose of the Study:
- To assess the utility of home uroflowmetry in evaluating boys with urinary incontinence.
- To correlate home uroflowmetry findings with videourodynamics results.
- To identify common urodynamic abnormalities associated with abnormal home uroflowmetry patterns.
Main Methods:
- Home uroflowmetry was conducted over a weekend in 39 boys with urinary incontinence.
- Uroflowmetry curves were analyzed for normal, obstructive, or small functional bladder capacity patterns.
- Videourodynamics and cystoscopy were performed in a subset of patients for comparison.
Main Results:
- Small functional bladder capacity was the most common finding (66%), followed by obstructive uropathy (21%) and normal uroflowmetry (13%).
- Abnormal home uroflowmetry (obstructive or small capacity) frequently correlated with bladder outlet obstruction and/or detrusor overactivity.
- Normal home uroflowmetry accurately predicted normal voiding function.
Conclusions:
- Home uroflowmetry is a reliable tool for detecting abnormal voiding in pediatric urinary incontinence.
- Obstructive home uroflowmetry and small functional bladder capacity are significant indicators of underlying bladder outlet obstruction and detrusor overactivity.
- These findings support the use of home uroflowmetry as a valuable diagnostic adjunct in pediatric urology.
Purpose:
We recorded uroflowmetry at home in boys with urinary incontinence and correlated the results with videourodynamics.
Materials And Methods:
Thirty-nine boys (mean age 8.4 +/- 2.0 years) with urinary incontinence underwent home uroflowmetry for 1 weekend. Artifactual spikes in 1 or more uroflow curves were present in 16 home uroflowmetry recordings. One patient, in whom none of the uroflow curves was interpretable, was excluded from the study. Of the remaining 38 boys 18 had monosymptomatic nocturnal enuresis, and 20 had nocturnal enuresis and diurnal voiding symptoms. Percentage expected bladder capacity is defined as functional/expected bladder capacity x 100%. Normal and obstructive home uroflowmetry levels are defined as functional bladder capacity at least 50% expected bladder capacity associated with multiple bell-shaped and obstructive uroflow curves, respectively. Small functional bladder capacity is defined as capacity less than 50% expected bladder capacity, regardless of uroflow patterns. Videourodynamics and cystoscopy were performed in 17 patients.
Results:
Normal home uroflowmetry was noted in 5 patients (13%), obstructive uropathy in 8 (21%) and small functional bladder capacity in 25 (66%). Urodynamically 3 boys with normal home uroflowmetry had normal voiding, and 6 with obstructive home uroflowmetry had bladder outlet obstruction (of whom 1 also had detrusor overactivity). In addition, of 8 boys with small functional bladder capacity 4 had detrusor overactivity, 3 had bladder outlet obstruction and 1 had both findings.
Conclusions:
Normal home uroflowmetry predicted normal voiding, and abnormal recordings implied abnormal voiding function in boys with incontinence. Bladder outlet obstruction and detrusor overactivity were frequently disclosed by obstructive home uroflowmetry and small functional bladder capacity.