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Effect of Voided Volume on Voiding Patterns and Reliability of Uroflowmetry-Electromyography Results in Children with
M Murat Dayanc1, Yusuf Kibar1, H Cem Irkilata1
1Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey.
Insights
Voided volume (VV) significantly impacts uroflowmetry (UF) patterns in children with lower urinary tract dysfunction (LUTD). Adjusting VV during testing is crucial for accurate UF-EMG results in pediatric LUTD evaluations.
Area of Science:
- Pediatric Urology
- Urodynamics
- Lower Urinary Tract Dysfunction
Background:
- Lower urinary tract dysfunction (LUTD) in children can manifest with varied uroflowmetry (UF) patterns.
- The influence of voided volume (VV) on the interpretation of UF results in pediatric patients is not fully understood.
Purpose of the Study:
- To investigate the relationship between voided volume (VV) and uroflowmetry (UF) patterns in children diagnosed with lower urinary tract dysfunction (LUTD).
- To determine if altered VV affects the classification of uroflow patterns, potentially leading to misdiagnosis.
Main Methods:
- Children with LUTD underwent simultaneous uroflowmetry (UF) and electromyography (EMG) testing.
- UF-EMG curves were classified into bell, staccato, intermittent, plateau, and tower patterns.
- Patients were grouped based on the ratio of their voided volume (VV) to expected bladder capacity (EBC).
Main Results:
- A total of 382 UF-EMG results from 143 children were analyzed.
- Higher VV relative to EBC was associated with an increased incidence of staccato patterns and a decreased incidence of tower patterns.
- Normal voiding patterns were most prevalent when VV was between 50-100% of EBC.
Conclusions:
- Voided volume significantly influences uroflowmetry patterns in children with LUTD.
- Testing with an appropriate VV is essential for accurate UF interpretation.
- Repeating uroflowmetry with normal VV is recommended when results exceed expected bladder capacity.
Objective:
To examine whether voided volume (VV) could change the uroflow patterns and result in children with lower urinary tract dysfunction (LUTD).
Methods:
Between January 2009 and May 2010, the children with LUTD were enrolled in this study. Uroflowmetry (UF) combined with electromyography (EMG) was performed two times and was reviewed independently by two urologists. UF-EMG curves were classified as bell, staccato, intermittent, plateau, and tower. Patients' expected bladder capacity (EBC) and VV were recorded. Patients were divided into four groups according to their VV and EBC. Group 1, VV <50% of EBC; group 2, VV between 50 and 100% of EBC; group 3, VV between 100 and 125% of EBC; group 4, VV >125% of EBC.
Results:
A total of 143 patients underwent UF-EMG at least two times and 382 results were obtained. Groups 1, 2, 3 and 4 consisted of 27, 60, 27 and 29 children, respectively. The percentages of normal, intermittent, plateau voiding patterns were 58.5, 12.8, 7.1% in group 1; 79.8, 5.4, 1.8% in group 2; 59.2, 8.5, 2.8% in group 3; and 37.2, 5.1, 2.6% in group 4, respectively. The percentages of staccato and tower pattern were 1.4, 20% in group 1; 9.1, 3.6% in group 2; 30, 0% in group 3; and 55.1, 0% in group 4, respectively. The rate of tower shape curve decreased as voided volume increased, but the rate of staccato curve increased as voided volume increased.
Conclusions:
In case of exceeding the EBC, the test should be repeated with normal VV when UF results are being evaluated.
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