Uroflowmetry with pelvic floor electromyography: inter-rater agreement on diagnosis of pediatric non-neurogenic voiding disorders

Faasse, Mark A.; Nosnik, Israel; Diaz-Saldano, Dawn; Hodgkins, Kavita S.; Liu, Dennis B.; Schreiber, Jennifer; Yerkes, Elizabeth B.

doi:10.1016/j.jpurol.2015.05.012

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Additionally, in another study, the authors reported that the ratio of the bladder wall thickness to the empty bladder wall thickness obtained from ultrasound, which is used to assess lower urinary tract symptoms in pediatric patients with dysfunctional voiding, could be used as a noninvasive, inexpensive, simple and rapid tool, but this still needs to be combined with other noninvasive diagnostic tests ( 9 ). The clinical symptoms related to dysfunctional voiding are nonspecific, and utilization of uroflowmetry - EMG could improve diagnosis and treatment ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

et al. 2018

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Objective:To compare standard urotherapy with a combination of urotherapy and biofeedback sessions and to determine the changes that these therapies promote in children with dysfunctional voiding.Patients and Methods:The data of 45 patients who participated in the study from January 2010 to March 2013 were evaluated. All patients underwent urinary system ultrasonography to determine post-void residual urine volumes and urinary system anomalies. All patients were diagnosed using uroflowmetry - electromyography (EMG). The flow pattern, maximum flow rate, and urethral sphincter activity were evaluated in all patients using uroflowmetry - EMG. Each patient underwent standard urotherapy, and the results were recorded. Subsequently, biofeedback sessions were added for all patients, and the changes in the results were recorded and statistically compared.Results:A total of forty - five patients were included, of which 34 were female and 11 were male and the average age of the patients was 8.4 ± 2.44 years (range: 5 - 15 years). After the standard urotherapy plus biofeedback sessions, the post-void residual urine volumes, incontinence rates and infection rates of patients were significantly lower than those with the standard urotherapy (p < 0.05). A statistically significant improvement in voiding symptoms was observed after the addition of biofeedback sessions to the standard urotherapy compared with the standard urotherapy alone (p < 0.05).Conclusions:Our study showed that a combination of urotherapy and biofeedback was more effective in decreasing urinary incontinence rates, infection rates and post - void residual urine volumes in children with dysfunctional voiding than standard urotherapy alone, and it also showed that this combination therapy corrected voiding patterns significantly and objectively.

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Section: Discussionmentioning

confidence: 99%

Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

et al. 2018

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“…In agreement with these studies, more recently, Faasse et al, 12 identified a low inter-rater agreement between six evaluators from the same institution even with additional information on patients' clinical symptoms provided. 12 The data described in these studies are in accordance with the results presented herein. Relative higher intra rater agreement for the smooth curve was observed for the classification proposed by ICCS (0.82), meaning that about one-fifth of the raters did not agree with themselves evaluating the same curve twice.…”

Section: Discussionmentioning

confidence: 63%

“…Both studies analyzed adult uroflows. In agreement with these studies, more recently, Faasse et al, 12 identified a low inter‐rater agreement between six evaluators from the same institution even with additional information on patients' clinical symptoms provided 12 …”

Section: Discussionmentioning

confidence: 65%

Interpretation of uroflow curves: A global survey measuring inter and intra rater reliability

Netto

Hittelman

Lambert

et al. 2020

Neurourology and Urodynamics

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Introduction: There is a large amount of intra and inter observer variability in defining curve shapes. This study aims to evaluate inter and intra rater reliability (RR) on evaluating uroflow curves in a broad spectrum of international practitioners.Methods: Eight hundred sixty-four questionnaires were sent by email to health professionals that care for children with voiding dysfunction. It included demographic questions and 11 different uroflow curves and two duplicates.

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“…The ICCS reported that adding EMG to uroflowmetry could be useful to interpret the results . Nonetheless, Faasse et al could only found a suboptimal inter‐rater agreement on the diagnosis of non‐neurogenic voiding disorders and suggested further research into explanatory mechanisms. This study intended to investigate testing procedure in healthy children, ultimately leading to the development of a reliable screening tool for voiding dysfunctions.…”

Section: Discussionmentioning

confidence: 99%

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

Samijn

Laecke

Walle

et al. 2018

Neurourology and Urodynamics

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Aims: To investigate if the standard protocol for uroflowmetry, recommended by the International Children's Continence Society, remains accurate when integrating EMG measurement by means of superficial electrodes. Methods: A cross-sectional study was conducted including healthy children. Group A performed two direct repetitions of uroflowmetry in combination with electromyography (uroflow/EMG). Group B performed a preceding measurement of isolated uroflowmetry, followed by two randomized measurements of uroflowmetry with and without EMG. Interpretation of uroflow curve was assessor blinded by a pediatric urologist and secondly performed using the flow index methodology. Statistical analysis compared different voids within each group and between group A and B. Results: Eighty-three children were included and 206 uroflow measurements were obtained. In both groups statistical findings confirmed the hypothesis that it is preferable to perform an additional measurement before the use of uroflow/EMG. Although both groups showed improvement between voids, the group with initial uroflow measurement followed by uroflow/EMG measurement showed more improvement in concern of curve pattern. An initially better first void in group A, but no statistical difference between the second void in group A and uroflow/EMG testing in group B further demonstrates a higher improvement in group B. This suggests the use of a precedent uroflowmetry without EMG is preferable to immediate testing with EMG.Conclusions: It should be mandatory to perform one measurement in advance to ensure the reliability of the results. It is suggested to initiate the procedure with a single uroflowmetry measurement followed by one measurement of uroflow with EMG testing.

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Uroflowmetry with pelvic floor electromyography: inter-rater agreement on diagnosis of pediatric non-neurogenic voiding disorders

Cited by 12 publications

References 20 publications

Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

Interpretation of uroflow curves: A global survey measuring inter and intra rater reliability

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

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