Wu Guoxing,Wu Ruifa,Li Honghui,et al.Application of free video uroflowmetry in the evaluation of lower urinary tract dysfunction in children[J].Journal of Clinical Pediatric Surgery,,():637-641.[doi:10.3760/cma.j.cn101785-20260330-00144]
Application of free video uroflowmetry in the evaluation of lower urinary tract dysfunction in children
- Abstract:
- Objective To investigate the feasibility and clinical value of free video uroflowmetry in evaluating lower urinary tract dysfunction (LUTD). Methods The data of free video uroflowmetry in children hospitalized for LUTD at Dongguan Children’s Hospital from January 2025 to July 2025 were retrospectively analyzed.During hospitalization,all children underwent free uroflowmetry (FF),video urodynamics (VUDS),and free video uroflowmetry (FVU).Accordingly,the examinations were divided into three groups:the free uroflowmetry group (FF group),the video urodynamics study group (VUDS group),and the free video uroflowmetry group (FVU group).Uroflowmetric parameters,including maximum flow rate,average flow rate,voiding time,voided volume,and postvoid residual urine volume,as well as positive imaging events,including the presence of vesicoureteral reflux,detrusor-sphincter dyssynergia,and pseudo-increased residual urine,were compared among the three groups.Results A total of 51 children were included in this study,including 28 boys and 23 girls,with a mean age of (7.49±2.09) years.There were no statistically significant differences between the FF and FVU groups in maximum flow rate,average flow rate,voiding time,voided volume,or postvoid residual urine volume (P>0.05).There were statistically significant differences between the FF and VUDS groups in maximum flow rate[(17.02±7.13) mL/s vs.(10.55±7.10) mL/s],average flow rate[(9.45±4.39) mL/s vs.(4.34±2.93) mL/s],voiding time[16.50 (13.00,27.00) s vs.41.00 (27.00,68.00) s],and postvoid residual urine volume[0.00 (0.00,20.00) mL vs.21.00 (10.00,70.00) mL](P<0.05).There were also statistically significant differences between the FVU and VUDS groups in maximum flow rate[(15.95±6.26) mL/s vs.(10.55±7.10) mL/s],average flow rate[(7.90±3.73) mL/s vs.(4.34±2.93) mL/s],voiding time[21.80 (15.90,31.00) s vs.41.00 (27.00,68.00) s],and postvoid residual urine volume[0.00 (0.00,22.00) mL vs.21.00 (10.00,70.00) mL](P<0.05).However,there were no statistically significant differences in voided volume between the FF and VUDS groups or between the FVU and VUDS groups (P>0.05).The detection rates of positive imaging events,including vesicoureteral reflux,detrusor-sphincter dyssynergia,and pseudo-increased residual urine,did not differ significantly between the FVU and VUDS groups (P>0.05).Conclusion Free video uroflowmetry can evaluate voiding function under conditions closer to natural voiding,while clearly displaying the morphological structure of the bladder and urethra and determining the presence of vesicoureteral reflux,detrusor-urethral sphincter dyssynergia,and pseudo-increased residual urine volume.It provides an effective method for medical institutions lacking pressure-flow studies or video urodynamic equipment,especially primary hospitals,to simultaneously obtain functional and morphological information of the bladder and urethra.
References:
[1] Marciano RC,Cardoso MGF,Vasconcelos MA,et al.Behavioral disorders and impairment of quality of life in children and adolescents with lower urinary tract dysfunction[J].J Pediatr Urol,2018,14(6):568.e1-568.e7.DOI:10.1016/j.jpurol.2018.07.017.
[2] 文建国.重视儿童下尿路功能障碍,推进尿动力学检查临床应用[J].中华医学杂志,2022,102(38):2981-2983.DOI:10.3760/cma.j.cn112137-20220531-01194. Wen JG.Pay attention to lower urinary tract dysfunction and the clinical application of urodynamic studies in children[J].Natl Med J China,2022,102(38):2981-2983.DOI:10.3760/cma.j.cn112137-20220531-01194.
[3] Drake MJ,Doumouchtsis SK,Hashim H,et al.Fundamentals of urodynamic practice,based on International Continence Society good urodynamic practices recommendations[J].Neurourol Urodyn,2018,37(S6):S50-S60.DOI:10.1002/nau.23773.
[4] Sch?fer W,Abrams P,Liao LM,et al.Good urodynamic practices:uroflowmetry,filling cystometry,and pressure-flow studies[J].Neurourol Urodyn,2002,21(3):261-274.DOI:10.1002/nau.10066.
[5] Hari P,Meena J,Kumar M,et al.Evidence-based clinical practice guideline for management of urinary tract infection and primary vesicoureteric reflux[J].Pediatr Nephrol,2024,39(5):1639-1668.DOI:10.1007/s00467-023-06173-9.
[6] Furrer MA,Kessler TM,Panicker JN.Detrusor sphincter dyssynergia[J].Urol Clin North Am,2024,51(2):221-232.DOI:10.1016/j.ucl.2024.01.001.
[7] Austin PF,Bauer SB,Bower W,et al.The standardization of terminology of lower urinary tract function in children and adolescents:update report from the standardization committee of the international children’s continence society[J].J Urol,2014,191(6):1863-1865.e13.DOI:10.1016/j.juro.2014.01.110.
[8] Stein R,Bogaert G,Dogan HS,et al.EAU/ESPU guidelines on the management of neurogenic bladder in children and adolescent part I diagnostics and conservative treatment[J].Neurourol Urodyn,2020,39(1):45-57.DOI:10.1002/nau.24211.
[9] Bauer SB,Nijman RJ,Drzewiecki BA,et al.International Chil-dren’s Continence Society Standardization Subcommittee.International Children’s Continence Society standardization report on urodynamic studies of the lower urinary tract in children[J].Neurourol Urodyn,2015,34(7):640-647.DOI:10.1002/nau.2278.
[10] Richard P,Ordonez NI,Tu LM.The effect of a 6 Fr catheter on flow rate in men[J].Urol Ann,2013,5(4):264-268.DOI:10.4103/0974-7796.120303.
[11] Groutz A,Blaivas JG,Sassone AM,et al.Detrusor pressure uroflowmetry studies in women:effect of a 7Fr transurethral catheter[J].J Urol,2000,164(1):109-114.DOI:10.1016/S0022-5347(05)67460-5.
[12] Valentini FA,Robain G,Hennebelle DS,et al.Decreased maximum flow rate during intubated flow is not only due to urethral catheter in situ[J].Int Urogynecol J,2013,24(3):461-467.DOI:10.1007/s00192-012-1856-2.
[13] Costantini E,Mearini L,Biscotto S,et al.Impact of different sized catheters on pressure-flow studies in women with lower urinary tract symptoms[J].Neurourol Urodyn,2005,24(2):106-110.DOI:10.1002/nau.20099.
[14] Duckett J,Cheema K,Patil A,et al.What is the relationship between free flow and pressure flow studies in women?[J].Int Urogynecol J,2013,24(3):447-452.DOI:10.1007/s00192-012-1883-z.
[15] Harding C,Horsburgh B,Dorkin TJ,et al.Quantifying the effect of urodynamic catheters on urine flow rate measurement[J].Neurourol Urodyn,2012,31(1):139-142.DOI:10.1002/nau.21188.
Memo
收稿日期:2026-3-30。
基金项目:国家自然科学基金项目(82470807、U1904208)
通讯作者:文建国,Email:jgwen@zzu.edu.cn