title: Dynamic pelvic floor ultrasound for lower urinary tract symptoms in children--initial report on normative values.
abstract: OBJECTIVE
  Lower urinary tract symptoms (LUTS) are common in children. The aim of this study was to determine normal values for pelvic floor movement in asymptomatic controls to allow comparison with symptomatic children with dysfunctional voiding (DV) in the next phase of the study.
  
  
  METHODS
  One hundred children between the ages of 5-17 years were recruited prospectively as controls. All were asked to perform a voluntary pelvic floor contraction manoeuvre with a full bladder. All scans were performed on a Vivid I GE ultrasound machine with a 4-9 MHz curvilinear probe. M Mode was used to determine the direction of pelvic floor (levator plate-LP) movement, the distance in cms and the endurance in seconds. Each measurement was taken 3 times.
  
  
  RESULTS
  Six children were unable to understand and perform the manoeuvre and were excluded. The median age was 10 years (range 4-17). The median LP movement was 0.3 cm (range 0.1-1.6) and cranial in 86/94 (91%). The median endurance time was 5.8 s (range 2.3-15.5). For the (n = 59) younger children aged 4-11, the 95% normal reference range for LP movement was 0.1 cm-1.4 cm and for endurance was 2.5-13.5 s. For the (n = 33) older children aged 12-17, the 95% normal reference range for LP movement was 0.2 cm-1.2 cm and for endurance was 2.3-15.5 s. There was a significant correlation (Pearson r = 0.39, P = 0.001) between average LP movement and endurance.
  
  
  CONCLUSIONS
  This study gives the normal reference ranges for the variables measured. A further study is currently underway examining the same variables in children with dysfunctional voiding (DV) and comparing these with the reference range.
authors: Sheffield Children's Hospital, Paediatric Urology, Sheffield, United Kingdom. Electronic address: prasadgodbole@btinternet.com.
authors: Prasad
authors: P
authors: Godbole
authors: Ashok
authors: A
authors: Raghavan
authors: Jo
authors: J
authors: Searles
authors: Julian
authors: J
authors: Roberts
authors: Stephen J
authors: SJ
authors: Walters
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D012016:Reference Values; D014463:Ultrasonography / Q000379:methods / Q000592:standards*; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000502:physiology; D014554:Urination; D014563:Urodynamics
keywords: Dysfunctional voiding; Lower urinary tract symptoms; Pelvic floor movement