Uroflowmetry in the management of lower urinary tract symptoms of children and adolescents with cerebral palsy.
OBJECTIVE
To evaluate uroflow measurements in the initial management of lower urinary tract dysfunction in children and adolescents with cerebral palsy.


METHODS
A total of 54 patients was enrolled in this study. All patients reported their urinary symptoms and underwent a physical examination, renal and urinary tract ultrasonography, and uroflow assessment.


RESULTS
Twenty-three patients were female. Mean age was 9 years and 6 months (SD: 2 years and 10 months), with a range of 5-18 years. Twenty-eight of the patients (51.8%) were symptomatic. Urgency (42.6%), urge incontinence (40.7%), and enuresis (16.7%) were the most frequently observed symptoms. No association was found between gender, ambulatory status, or distribution of the paralysis and uroflow parameters. Symptomatic patients presented a statistically lower maximum flow (Qmax) than asymptomatic patients (17.2 ± 7.8 ml/s vs 22.6 ± 7.5 ml/s, p = 0.013, respectively). Normal bell-shaped curves were observed more frequently in asymptomatic patients, while abnormal curves were observed more frequently in symptomatic patients (p = 0.022).


CONCLUSIONS
Gender, ambulatory status, and the distribution of the paralysis do not affect Qmax rate or flow pattern. Symptomatic patients present lower Qmax and may also have an abnormal uroflow curve. Uroflowmetry may be useful in the initial urological evaluation.
Division of Urology, Pedro Ernesto Memorial Hospital, State University of Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 77 - Vila Isabel, Rio de Janeiro 55-20551-030, Brazil. Electronic address: urocentre@hotmail.com.
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Fernandes Silva
Division of Urology, Pedro Ernesto Memorial Hospital, State University of Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 77 - Vila Isabel, Rio de Janeiro 55-20551-030, Brazil.
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Borges Carrerette
Division of Urology, Pedro Ernesto Memorial Hospital, State University of Rio de Janeiro, Boulevard Vinte e Oito de Setembro, 77 - Vila Isabel, Rio de Janeiro 55-20551-030, Brazil.
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Damião
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012212:Rheology / Q000379:methods*; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014563:Urodynamics / Q000502:physiology*
Cerebral palsy; Child; Lower urinary tract symptoms; Urodynamics