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Non-invasive bladder function measures in healthy, asymptomatic female children and adolescents: A systematic review
Melanie R Meister1, Jincheng Zhou2, Haitao Chu3
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Kansas, Kansas City, KS, USA.
Insights
This study aimed to define normative reference ranges for bladder function tests in healthy girls. Due to limited data and wide age ranges, results cannot be generalized, and further research is needed.
Area of Science:
- Pediatric Urology
- Bladder Function Assessment
- Normative Data
Background:
- Lower urinary tract symptoms (LUTS) are prevalent in pediatric populations.
- Non-invasive bladder function tests are preferred, but normative data in healthy children are scarce.
- Understanding normal bladder function is crucial for diagnosing LUTS.
Purpose of the Study:
- To establish normative reference ranges for non-invasive bladder function tests in healthy, asymptomatic girls and adolescents.
- To synthesize existing data on voiding frequency, postvoid residual volumes (PVR), and uroflowmetry.
- To provide a basis for interpreting bladder function tests in pediatric patients.
Main Methods:
- A systematic literature search was conducted across seven databases up to October 2019.
- Included studies reported data on bladder function parameters in healthy girls aged 5 years and older.
- Meta-analysis was used to calculate pooled mean estimates and confidence intervals for various parameters.
Main Results:
- Ten studies with 2143 girls (ages 3-18) were included.
- Pooled estimates for maximum voided volume and PVR were calculated.
- Uroflowmetry parameters like maximum flow rate and voided volume were estimated, but voiding frequency data were unavailable.
Conclusions:
- Pooled mean estimates for several bladder function parameters were derived.
- High heterogeneity and limited studies/wide age ranges restrict generalization of findings.
- Further research is necessary to establish age-specific normative reference values for pediatric bladder function.
Background:
Lower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children.
Objective:
To define normative reference ranges for non-invasive tests of bladder function in healthy, asymptomatic girls and adolescents.
Study Design:
A comprehensive search strategy was performed in seven electronic databases through October 2019. English-language studies reporting data on voiding frequency, voided and postvoid residual volumes (PVR) and uroflowmetry results in healthy, asymptomatic girls (mean age ≥ 5 years) were included. Two independent reviewers performed study review, data extraction, and quality assessment. Overall mean estimates and 95% confidence intervals for each bladder function parameter were calculated using random effects models, and 95% normative reference values were estimated.
Results:
Ten studies met eligibility criteria for the meta-analysis (n = 2143 girls, age range: 3-18). Mean estimates of maximum voided volume and PVR were 233.4 ml (95% CI 204.3-262.6; n = 1 study) and 8.6 ml (95% CI 4.8-12.4; n = 2 studies) respectively. Pooled mean estimates for uroflowmetry parameters were: 21.5 ml/s (95% CI 20.5-2.5) for maximum flow rate (n = 6 studies), 12.5 ml/s (95% CI 11.2-13.8) for mean flow rate (n = 6 studies), 6.8 s (95% CI 4.4-9.3) for time to maximum flow (n = 3 studies), 15.7 s (95% CI 13.0-18.5) for flow time (n = 3 studies), and 198.7 ml (95% CI 154.2-234.2) for voided volume (n = 9 studies). No studies reported estimates of voiding frequency. Between-study heterogeneity was high (89.0-99.6%).
Conclusions:
Although we were able to calculate pooled mean estimates for several parameters, the small number of included studies and the wide age ranges of participants preclude generalization of reference values to all healthy girls. Further research is needed to determine normative reference values within specific age groups.
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