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Role of uroflowmetry with electromyography in the evaluation of children with lower urinary tract dysfunction
1Department of Pediatric Urology, Sri Ramachandra Medical College, Porur, Chennai, India.
Insights
Uroflowmetry with electromyography (UFEMG) is a superior, non-invasive test for diagnosing lower urinary tract dysfunction in children. This method effectively identifies various voiding abnormalities, unlike conventional urodynamic studies.
Area of Science:
- Pediatric Urology
- Urodynamics
- Lower Urinary Tract Dysfunction
Background:
- Conventional urodynamic studies (UDS) are invasive and uroflowmetry alone is insufficient for evaluating pediatric lower urinary tract dysfunction (LUTD).
- There is a need for a more effective, non-invasive diagnostic tool in this patient population.
Purpose of the Study:
- To evaluate the diagnostic role and effectiveness of uroflowmetry with electromyography (UFEMG) in children with LUTD.
- To compare the diagnostic yield of UFEMG with conventional UDS.
Main Methods:
- A prospective study of 121 children (aged 5-12 years) with LUTD symptoms was conducted.
- Children underwent UFEMG followed by UDS on the same day, excluding those with neurological abnormalities, obstructive uropathy, or active UTIs.
Main Results:
- UFEMG identified abnormalities in 76 (63%) children, significantly more than UDS which found abnormalities in only 12 (10%) (P = 0.03).
- Three distinct UFEMG patterns were observed: dysfunctional voiding (n=42), idiopathic detrusor overactivity (n=16), and detrusor underutilization disorder (n=18).
Conclusions:
- UFEMG is an ideal non-invasive diagnostic test for children experiencing lower urinary tract dysfunction.
- UFEMG aids in differentiating specific voiding patterns, guiding appropriate treatment strategies for pediatric LUTD.
Introduction:
A conventional urodynamic study (UDS) is considered invasive while uroflowmetry is considered inadequate in the evaluation of children with lower urinary tract dysfunction. The aims of this study were to identify the role of uroflowmetry with electromyography (UFEMG) in this group.
Methods:
A cohort of 121 children (age 5-12 years; M:F = 2:3) with symptoms of lower urinary tract dysfunction underwent a detailed voiding history and clinical assessment. Those with evidence of neurological abnormality, obstructive uropathy or active urinary tract infection were not included. They were prospectively studied using UFEMGfirst, followed by UDS on the same day.
Results:
A total of 76 (63%) children had abnormality on UFEMG while only 12 (10%) had abnormality on UDS. UFEMG was significantly superior in picking up abnormality (P = 0.03). Three types of UFEMG abnormalities were identified: (1) dysfunctional voiding (prolonged staccato trace with active pelvic floor and normal voided volume: n = 42), (2) idiopathic detrusor overactivity (shortened trace with quiet pelvic floor and reduced voided volume: n = 16) and (3) detrusor underutilization disorder (prolonged flat trace with quiet pelvic floor and large voided volume: n = 18).
Conclusions:
UFEMG is ideal non-invasive test in children with lower urinary tract dysfunction. It helps in identifying the different patterns and the appropriate treatment modality.
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