Uroflow measurement combined with electromyography testing of the pelvic floor in healthy children

Samijn, Bieke; Laecke, Erik Van; Walle, Johan Vande; Pascal, Aurelie; Deschepper, Ellen; Renson, Catherine; Broeck, Christine Van den

doi:10.1002/nau.23836

Cited by 6 publications

(6 citation statements)

References 23 publications

(43 reference statements)

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“…Although the LUTDSS of those patients was higher than 8.5, their UF-EMG findings were similar with the control group. Samijn et al (12) reported 50-60% of children with LUTS void on the bell-shaped curve and suggested that initiation to the procedure with a UF alone and followed by a measurement of UF with EMG. Similar with this study, we have found the rate of Grade 0 and Grade 1 which were bell shaped curve in 54% of the patient.…”

Section: Resultsmentioning

confidence: 99%

“…LUTDSS is a diagnostic tool for the diagnosis of LUTD in children with a score of 8.5 or greater had voiding abnormalities, with 90% sensitivity and 90% specifity (10). The questionnaire was composed of the following items: daytime urinary incontinance (Q1,2), nighttime urinary incontinance (Q3,4), frequency (Q5), voiding habits as strain, pain during voiding, intermittency (Q6,7,8,9), bladder habits as urgency and urge incontinance (Q10, 11,12), constipation (Q13) and quality of life. UF-EMG studies were performed by the expert nurse (MMS 5000, Medical measurement system 5000, USA) in our urodinamy study center.…”

Section: Methodsmentioning

confidence: 99%

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A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

Köprü¹,

Ergin

Ebiloğlu³

et al. 2021

Anatolian Current Medical Journal

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Aim: It is recommended that dysfunctional voiding diagnosis should made by the repeated uroflowmetry simultaneously pelvic floor electromyography (UF-EMG) + post-void residual measurements. However, there is no evaluation system for UF-EMG parameters regarding the clinical diagnosis, follow up and treatment of these patients. In our study, we aimed to create a new grading system for the diagnosis of dysfunctional voiding by using UF-EMG parameters. Material and Method: We have retrospectively obtained UF-EMG and lower urinary tract symptom score results that performed to the children whom applied to our clinic with the symptoms of dysfunctional voiding between 2010 and 2015. A total of 856 reports were included into this retrospective cohort analysis. The proper 610 UF-EMG tests were graded according to our grading system. The UF-EMG grading system is divided into 6 grades: Grade 0: No EMG activity and normal uroflowmetry, Gradenon-EMG: Disturbed flow pattern with no EMG activity, Grade 1: EMG activity with no disturbed flow pattern, Grade 2: EMG activity with minimally disturbed flow pattern, Grade 3: EMG activity with moderately disturbed flow pattern, Grade 4: EMG activity with extremely disturbed flow pattern. Results: There was no statistically significant difference between the demographic data of patient and control groups (p>0.05). According to grading system, day and nighttime incontinence were statistically significant increases as the grades increases (respectively, p<0,001, p=0,023). According to grading system we created as the grades increased the UF-EMG parameters and the questions of lower urinary tract dysfunction symptom score which evaluated the voiding phase results were statistically significant (p<0.05). Conclusion: Grading system will be helpful to interpreting the results of the UF-EMG, which considered to be relatively difficult and thus, the diagnosis of the patients can be easier to evaluate and respond to the treatment by urologist.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

Köprü¹,

Ergin

Ebiloğlu³

et al. 2021

Anatolian Current Medical Journal

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“…Although a repeated UF was conducted when possible, there is still a possibility that the patching of EMG itself affected EMG relaxation and urination by causing discomfort and anxiety to the patients. 14…”

Section: Discussionmentioning

confidence: 99%

“…Though the examiner performed inspections, simultaneous audio monitoring to confirm the absence of motor activity during voiding was not performed to assess the EMG artifact. Although a repeated UF was conducted when possible, there is still a possibility that the patching of EMG itself affected EMG relaxation and urination by causing discomfort and anxiety to the patients 14 …”

Section: Discussionmentioning

confidence: 99%

The relationship among flow index, uroflowmetry curve shape, and EMG lag time in children

Lee

Han

et al. 2020

Neurourology and Urodynamics

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Purpose To determine the relationship among flow index (FI), uroflowmetry curve shape, and electromyography (EMG) lag time in children. Materials and Methods A total of 294 children with lower urinary tract symptoms were included. The overall relationship between lag time and FI was investigated with curve estimation regression. Normal and primary bladder neck dysfunction was defined according to the previous classification, while patients with a lag time less than 2 seconds were grouped based on 2‐second intervals. We also categorized cases into four groups (tower shaped, bell shaped, plateau shaped, and fractionated void) by FI and compared lag time. Results The overall distribution chart demonstrated that FI was the highest at lag time 0 second and decreased with the change in lag time both ways. The best fitting model for maximum FI and lag time was a cubic model (R2 = .282; P < .001). Children with lag times from 0 to less than 2 seconds showed the highest mean FI, while those with prolonged (>6 seconds) or delayed lag time (<−4 seconds) demonstrated lower mean FI values. EMG lag time of the tower‐shaped curve was significantly close to 0 second, and plateau shaped and fractionated void had either prolonged or delayed. Conclusions A lag time close to 0 second was associated with higher FI, representing hyperefficient voiding with a tower‐shaped flow pattern. However, children with prolonged or delayed lag time showed a lower FI, implicating hypoefficient voiding and a plateau‐shaped flow pattern. The relationship between FI and EMG lag time could be a cornerstone for a comprehensive understanding of voiding status.

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“…Uroflowmetry was reported to be a diagnostic tool which is comfortable for patients, relatively inexpensive, and time-efficient procedure which shows the natural voiding pattern in children (6)(7)(8) . It gives the results of voiding speed, voided volume, and voiding curve (9) . Uroflowmetry has a high sensitivity but low specificity, which might interfere with the diagnosis (10) .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Conventional Uroflowmetry and New Smart, Self-Directed Outpatient Uroflowmetry in the Evaluation of Lower Urinary System Dysfunction in Children

Devrim¹,

Dinçel²

2020

BUCH

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Objective: Uroflowmetry is an essential noninvasive test with important diagnostic method in patients with initial diagnosis of lower urinary tract dysfunction. We aimed to compare the results of conventional uroflowmetry with those of the new smart "self-directed outpatient" uroflowmetry in children with suspected lower urinary tract dysfunction. Methods: This cross-sectional study included children who had performed two sequential urinations in the same day recorded by conventional and smart "self-directed outpatient" uroflowmetry. Results of the measurements of maximum, and average urinary flow rates were recorded and compared. Results: The mean difference between average urinary flow rates detected by both diagnostic methods was-1.7. The Bland-Altman plot showed that most of the data points were tightly clustered around the zero line of the difference between the measurements, with only 4% of the readings falling outside the 95% level of confidence. The mean difference between average urinary flow rates measured by both conventional and "self-directed outpatient" uroflowmetry was-4.5. The Bland-Altman plot showed that most of the data points were tightly clustered around the zero line of the difference between the measurements, with only 2% of the readings falling outside the 95% level of confidence. Discussion: The maximum, and average urinary flow rates measured with "self-directed outpatient" uroflowmetry were statistically significantly higher compared to conventional uroflowmetry. These results could be due to the children being much shyer and being affected by the presence of someone in the room while urinating. Conclusion: The maximum urinary flow rate and average urinary flow rate measured with "self-directed outpatient" uroflowmetry are higher compared to conventional uroflowmetry, which might ensure patient privacy.

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Uroflow measurement combined with electromyography testing of the pelvic floor in healthy children

Cited by 6 publications

References 23 publications

A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

The relationship among flow index, uroflowmetry curve shape, and EMG lag time in children

Comparison of Conventional Uroflowmetry and New Smart, Self-Directed Outpatient Uroflowmetry in the Evaluation of Lower Urinary System Dysfunction in Children

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