Dynamic pelvic floor ultrasound for lower urinary tract symptoms in children--initial report on normative values

Area of Science:

• Pediatric Urology
• Pelvic Floor Imaging
• Lower Urinary Tract Symptoms (LUTS)

Background:

• Lower urinary tract symptoms (LUTS) are prevalent in children.
• Establishing normative data for pelvic floor function is essential for diagnosing conditions like dysfunctional voiding (DV).

Purpose of the Study:

• To determine normal pelvic floor movement values in asymptomatic children.
• To provide reference ranges for levator plate (LP) movement and endurance.
• To establish a baseline for comparison with children experiencing dysfunctional voiding (DV).

Main Methods:

• Prospective recruitment of 100 asymptomatic children aged 5-17 years.
• Ultrasound imaging (Vivid I GE, 4-9 MHz curvilinear probe) with M Mode to assess pelvic floor contraction.
• Measurement of levator plate (LP) movement distance (cm) and endurance (s) during voluntary contraction with a full bladder.

Main Results:

• Data from 94 children were analyzed (median age 10 years).
• Median levator plate (LP) movement was 0.3 cm (range 0.1-1.6 cm), predominantly cranial (91%).
• Median endurance time was 5.8 seconds (range 2.3-15.5 s), with significant correlation between LP movement and endurance (r=0.39, P=0.001).
• Normal reference ranges for LP movement and endurance were established for younger (4-11 years) and older (12-17 years) pediatric age groups.

Conclusions:

• This study provides the first normal reference ranges for pelvic floor movement variables in children.
• These established ranges are vital for future comparative studies in pediatric dysfunctional voiding (DV).
• Ongoing research will compare these normative values with those from children diagnosed with DV.