Interpretation of uroflowmetry in the paediatric population
1 Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland. Head of the Department: Associate Professor Bolesław Kalicki, MD, PhD
2 Medical Centre for Urodynamic Diagnosis URO-DYN, Warsaw, Poland
Correspondence: Magda Rakowska, Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medice, Szaserów 128, 04-141 Warsaw, Poland, tel.: +48 261 817 236, fax: +48 22 515 05 85, e-mail: mrakowska@wim.mil.pl
Pediatr Med Rodz 2017, 13 (1), p. 40–52
DOI: 10.15557/PiMR.2017.0004
ABSTRACT

Uroflowmetry is a simple, non-invasive examination that should be the first test in the diagnostic process of lower urinary tract disorders in children. It is applicable particularly in the paediatric population where a comprehensive urodynamic examination, involving urinary bladder catheterisation, is frequently difficult due to the lack of cooperation with children. It must be remembered that the prerequisite for optimal uroflowmetry is recreating natural conditions of micturition. When interpreting results, one must assess the uroflow curve, which is a resultant of urethral resistance and pressure inside the urinary bladder. That is why the main paediatric disorders that can be suspected after uroflowmetry include a functional or anatomical subcystic barrier and hyperactivity of the detrusor muscle of the urinary bladder. In normal conditions, the uroflow curve resembles a bell. An abnormal curve can be flattened, tower-shaped or irregular, but none of them is pathognomonic for a given urinary pathology. After a preliminary interpretation of the curve, one must assess whether the calculated micturition parameters, such as maximum flow and average flow rates, are within normal ranges. For this purpose, age- and sex-specific nomograms have been created. The final part of uroflowmetry involves the evaluation of post-void residual urine volume. Currently, ultrasound scan is the recommended method. It has been shown that post-void residual urine volume decreases with age and depends upon sex and bladder capacity. It must be emphasised that one abnormal result of uroflowmetry requires re-examination. Moreover, the results should be interpreted in combination with patient’s medical history.

Keywords: uroflowmetry, urethral flow, urodynamic examination, uroflow curve