Uroflowmetry, the simple, non-invasive measurement of urine flow over time during micturition, has a long and interesting history, clear definitions, a clear purpose in screening for voiding difficulty and, most importantly, technical accuracy. Data interpretation is currently limiting its clinical utility, despite appropriate analysis being available in long-standing existing research. The main clinically important numerical parameters are the maximum and average urine flow rates and the voided volume. Urine flow rates are strongly dependent on voided volume. Reference to established (Liverpool) nomograms will most accurately correct for this dependency. Nomograms will also optimise the validation of uroflowmetry data and the accurate assessment of its normality, compared with fixed urine flow rates and "cutoffs" for voided volume. Abnormally slow urine flow (under the 10th centile Liverpool Nomograms) is the most clinically significant abnormality. Repeat uroflowmetry, concomitant post-void residual measurement and voiding cystometry studies are appropriate options for evaluating any abnormal uroflowmetry.
The aim of this study is to assess the diagnostic relevance of the presenting bladder volume (PBV) at urodynamics in women. Its measurement is most accurately made by adding the voided volume at uroflowmetry and the postvoid residual. The study involved 1,140 women presenting for their initial urogynecological assessment. Multivariate analysis of the relationships between high or low PBVs and different clinical and urodynamic variables. Median PBV was 174 mL. In overall terms, women with lower PBVs (0-174 mL) are significantly more likely to be older, of lower parity (0-1), have the symptom of nocturia, and the final diagnoses of sensory urgency and detrusor overactivity. These women are significantly less likely to have posterior vaginal and apical vaginal prolapse. Women with higher PBVs (over 174 mL) are significantly less likely to have either bladder storage diagnoses. The relatively low median PBV might reduce the demonstration of clinical stress leakage and restrict the interpretation of uroflowmetry data.
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