title: Use of non-invasive uroflowmetry with simultaneous electromyography to monitor patient response to treatment for lower urinary tract conditions.
abstract: OBJECTIVE
  Non-invasive uroflowmetry with simultaneous electromyography (uroflow/EMG) has previously been reported as effective in triaging patients into four specific non-neurogenic lower urinary tract (LUT) conditions for targeted treatment. In this study we sought to determine if the same parameters would be useful for measuring response to treatment.
  
  
  METHODS
  We reviewed our database of normal children with LUT dysfunction, screened with uroflow/EMG, and diagnosed with a LUT condition: (1) dysfunctional voiding (DV); (2) idiopathic detrusor overactivity disorder (IDOD); (3) detrusor underutilization disorder (DUD); (4) primary bladder neck dysfunction (PBND). Pre- and on-treatment (minimum 3 months) uroflow/EMG parameters and subjective improvements were compared.
  
  
  RESULTS
  Of 159 children (71 boys, 88 girls; median age 7.0 years, range 3.5-18.0 years), median follow up was 13.1 months (range 3-43 months). On targeted treatment, DV patients showed relaxation of pelvic floor during voiding and significant decrease in PVR on biofeedback; IDOD patients had normalization of short lag time and increased capacity on antimuscarinics; DUD patients had a decrease in capacity on timed voiding; PBND patients on alpha-blocker therapy showed improved uroflow rates and a decrease in mean EMG lag time (all p < 0.05).
  
  
  CONCLUSIONS
  Non-invasive uroflow/EMG is useful not only for diagnosing specific LUT conditions, but also in objectively monitoring treatment efficacy. Subjective improvement on targeted therapy correlates well with objective improvements in uroflow/EMG parameters lending validation to this simplified approach to diagnosis.
authors.affiliation: Division of Pediatric Urology, Department of Urology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York - Presbyterian, 3959 Broadway, CHN 1118, New York, NY 10032, USA. Electronic address: jpv2107@columbia.edu.
authors.forename: J P
authors.initials: JP
authors.lastname: Van Batavia
authors.affiliation: Division of Pediatric Urology, Department of Urology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York - Presbyterian, 3959 Broadway, CHN 1118, New York, NY 10032, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Combs
authors.affiliation: Division of Pediatric Urology, Department of Urology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York - Presbyterian, 3959 Broadway, CHN 1118, New York, NY 10032, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Fast
authors.affiliation: Division of Pediatric Urology, Department of Urology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York - Presbyterian, 3959 Broadway, CHN 1118, New York, NY 10032, USA. Electronic address: kglassberg@aol.com.
authors.forename: K I
authors.initials: KI
authors.lastname: Glassberg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004576:Electromyography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D017773:Pelvic Floor / Q000503:physiopathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012212:Rheology / Q000379:methods*; D013997:Time Factors; D001743:Urinary Bladder / Q000503:physiopathology*; D014555:Urination Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*
keywords: Dysfunctional voiding; Electromyography; Overactive bladder; Pediatrics; Uroflowmetry; Voiding disorders