title: Comparison of uroflow parameters in children with pure constipation versus constipation plus lower urinary tract symptoms.
abstract: OBJECTIVE
  The aim of this study was to compare uroflow parameters of patients with pure constipation against those with constipation plus lower urinary tract symptoms (LUTS) and a control group (no constipation).
  
  
  METHODS
  During August 2012 to March 2014 three groups of patients were enrolled into the study: group C (constipation only), group CL (LUTS plus constipation) and group N (control: no constipation or LUTS). Dysfunctional elimination syndrome (DES) scores, uroflowmetry/electromyography (uroflow-EMG) findings, postvoiding residual urine (PVR) and rectal diameter were measured and compared between groups.
  
  
  RESULTS
  Groups C, CL and N comprised 80, 100 and 30 patients, respectively. Average DES scores were 12.6, 18.7 and 4.9, respectively. Voided volume (as a percentage of expected bladder capacity) was 104%, 89% and 101%; and average maximum flow rate was 21.1 ml/s, 36.4 ml/s and 28.1 ml/s, respectively. Pelvic floor muscle activity during voiding was seen in 40.0%, 42.0% and 6.7% of patients in groups C, CL and N, respectively; and pathological PVR was seen in 26.3%, 55.0% and 3.3% of patients in the respective groups. Average rectal diameter was measured as 38.6 mm, 36.4 mm and 28.1 mm in groups C, CL and N, respectively.
  
  
  CONCLUSIONS
  This study found that abnormal voiding parameters are present in patients with constipation even if LUTS are not present. Therefore, it is important that all patients presenting with constipation have their voiding function evaluated.
authors.affiliation: a 1 Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Aybegüm
authors.initials: A
authors.lastname: Kalyoncu
authors.affiliation: b 2 Department of Pediatric Surgery, Pendik State Hospital , Istanbul, Turkey.
authors.forename: David Terence
authors.initials: DT
authors.lastname: Thomas
authors.affiliation: a 1 Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Tural
authors.initials: T
authors.lastname: Abdullayev
authors.affiliation: c 3 Pediatric Urodynamics & Biofeedback Unit, Division of Pediatric Urology, Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Ayten
authors.initials: A
authors.lastname: Kaynak
authors.affiliation: c 3 Pediatric Urodynamics & Biofeedback Unit, Division of Pediatric Urology, Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Cansu
authors.initials: C
authors.lastname: Kastarli
authors.affiliation: d 4 Department of Radiology, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Mazican
authors.affiliation: e 5 Division of Pediatric Urology, Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Tolga E
authors.initials: TE
authors.lastname: Dagli
authors.affiliation: e 5 Division of Pediatric Urology, Department of Pediatric Surgery, Marmara University School of Medicine , Istanbul, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Tugtepe
keywords: Constipation; lower urinary tract symptoms; uroflow