A comparative study between EMG uroflowmetry with and without a catheter in children.
Shayel Bercovich1, Roy Morag2, Bezalel Sivan2
1Urology Unit - Schneider Children's Medical Center of Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Petach Tikva, Tel Aviv, 4941492, Israel. shayelb11@gmail.com.
BMC Urology
|September 6, 2024
Summary
Urethral catheterization in pressure-flow (PF) studies reduced the accuracy of EMG uroflowmetry in children with voiding disorders. Non-invasive EMG uroflowmetry is recommended for accurate diagnosis and treatment planning in pediatric patients.
Area of Science:
- Pediatric Urology
- Urodynamics
- Pelvic Floor Dysfunction
Background:
- Accurate urodynamic evaluation is crucial for diagnosing non-neurogenic voiding disorders in children.
- Pressure-flow (PF) studies using urethral catheterization are a common method, but their accuracy with EMG uroflowmetry is debated.
- Non-invasive EMG uroflowmetry serves as a benchmark for assessing voiding function.
Purpose of the Study:
- To compare the accuracy of EMG uroflowmetry during invasive PF studies versus non-invasive EMG uroflowmetry in children.
- To evaluate the impact of urethral catheterization on the reliability of urodynamic measurements.
- To identify potential diagnostic discrepancies between the two methods.
Main Methods:
- Retrospective analysis of 104 children undergoing urodynamic evaluation (8/2018–7/2022).
- Comparison of urination curves and pelvic floor muscle activity between PF studies and non-invasive EMG uroflowmetry.
- Non-invasive EMG uroflowmetry was used as the reference standard.
Main Results:
- 33% of children could only urinate during non-invasive testing.
- Boys had a significantly higher rate of inability to void with a catheter (54% vs. 13%).
- PF studies showed lower specificity (39%) and PPV (61%) for detecting abnormal voiding curves compared to non-invasive methods.
Conclusions:
- Invasive PF studies demonstrate poor accuracy for EMG uroflowmetry in pediatric patients, particularly boys.
- This inaccuracy may lead to misdiagnosis and inappropriate treatment strategies.
- Non-invasive EMG uroflowmetry is recommended, especially when children refuse catheterization or abnormal findings necessitate treatment adjustments.
