The Effects of Voiding Habits on Uroflowmetry in Childhood

Abstract

Background: Urodynamic studies (UDS) is a simple non-invasive test to assess lower urinary tract function but it may be affected by several factors includes age, sex, voiding volume and voiding position. These interventional parameters become more highlighted while performing UDS in children whose emotional stress control and coping with unfamiliar situation is more difficult. Methods: Seventy six primary school age healthy children underwent screening uroflowmetry in different voiding positions voluntarily. Cases with urinary symptoms, other coexisting diseases, voiding volume less than 20cc or staccato voiding curve were excluded. Washrooms were designed in both western and eastern styles. UDS indexes were compared regarding voiding habits. Results: Comparison of uroflowmetric indexes between different genders and voiding positions showed differences which were not statistically significant but considering the voiding habits, uroflowmetric indexes were significantly different in familiar compare to unfamiliar voiding position. Q-Max was lower and time to Q-Max and micturition time were longer in unfamiliar voiding position. Conclusions: Urodynamic studies in children should be performed in preferred voiding position for each kid considering the culture and voiding habits. Unfamiliar voiding position may turn the uroflowmetry to a stressful experience for child that make him uncooperative and cause misleading results.

Uroflowmetry parameters in healthy children between 5 and 15 years old

“…In recent studies, it has been reported that UFM values of the age group of 11-15 years differ significantly when compared with the lower age groups, and therefore the children have been divided into age groups in terms of UFM results. 19,26,28,30,31,39 Our results were similar to other studies, and the Qmax and Qavg values in girls were significantly higher than in boys in both age groups. This finding has been related to the increase in VV with age and the proportionality of urine flow rate with increasing VV.…”

“…Some studies suggest higher VVs in girls than in boys, 13,28 while others disagree. 39 A study comparing VVs in children using different toilet styles found significantly higher VVs with Turkish-style toilets. 39 In our study, girls had a slightly lower mean VV than boys, but the difference was not statistically significant.…”

“…39 A study comparing VVs in children using different toilet styles found significantly higher VVs with Turkish-style toilets. 39 In our study, girls had a slightly lower mean VV than boys, but the difference was not statistically significant. Unlike some studies, we used toilet bowls for both genders, which may have facilitated easier bladder emptying for boys.…”

“…It is unclear whether voiding habits change UFM parameters. [39][40][41] Urinating in an unusual position may be a stress factor, and this may prevent an accurate estimation of the urine flow rate. 26 In some studies, it is stated that the habit of voiding should be at the forefront rather than a voiding position, otherwise the child may become stressed and embarrassed.…”

“…Some studies suggest higher VVs in girls than in boys, 13,28 while others disagree 39 . A study comparing VVs in children using different toilet styles found significantly higher VVs with Turkish‐style toilets 39 .…”