Home uroflowmetry for the evaluation of boys with urinary incontinence.
OBJECTIVE
We recorded uroflowmetry at home in boys with urinary incontinence and correlated the results with videourodynamics.


METHODS
Thirty-nine boys (mean age 8.4 +/- 2.0 years) with urinary incontinence underwent home uroflowmetry for 1 weekend. Artifactual spikes in 1 or more uroflow curves were present in 16 home uroflowmetry recordings. One patient, in whom none of the uroflow curves was interpretable, was excluded from the study. Of the remaining 38 boys 18 had monosymptomatic nocturnal enuresis, and 20 had nocturnal enuresis and diurnal voiding symptoms. Percentage expected bladder capacity is defined as functional/expected bladder capacity x 100%. Normal and obstructive home uroflowmetry levels are defined as functional bladder capacity at least 50% expected bladder capacity associated with multiple bell-shaped and obstructive uroflow curves, respectively. Small functional bladder capacity is defined as capacity less than 50% expected bladder capacity, regardless of uroflow patterns. Videourodynamics and cystoscopy were performed in 17 patients.


RESULTS
Normal home uroflowmetry was noted in 5 patients (13%), obstructive uropathy in 8 (21%) and small functional bladder capacity in 25 (66%). Urodynamically 3 boys with normal home uroflowmetry had normal voiding, and 6 with obstructive home uroflowmetry had bladder outlet obstruction (of whom 1 also had detrusor overactivity). In addition, of 8 boys with small functional bladder capacity 4 had detrusor overactivity, 3 had bladder outlet obstruction and 1 had both findings.


CONCLUSIONS
Normal home uroflowmetry predicted normal voiding, and abnormal recordings implied abnormal voiding function in boys with incontinence. Bladder outlet obstruction and detrusor overactivity were frequently disclosed by obstructive home uroflowmetry and small functional bladder capacity.
Yang
Stephen Shei Den
SS
Department of Urology, En Chu Kong Hospital, School of Medicine, Taipei Medical University, Taiwan.
Wang
Chung Cheng
CC
Chen
Yung Tai
YT
D002648:Child; D003559:Cystostomy; D003937:Diagnosis, Differential; D004775:Enuresis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009122:Muscle Hypertonia / Q000175:diagnosis / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000503:physiopathology; D014549:Urinary Incontinence / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D014741:Video Recording