Comparison of uroflowmetry between women suffering from low urinary tract symptoms or cystoceles and liverpool normograms of normal women

الملخص EN

Objective: To investigate uroflow shapes and parameters in women suffering from low urinary tract symptoms LUTS) or cystocyles, and to compare their maximum flow rates with Liverpool Normograms of normal women (Qmax on Liverpool).

Methods: This is a cross-sectional study on women with low urinary tract symptoms (LUTS) or cystocyles who visited urodynamic units of Aleppo University Hospitals between 2007 and 2016, who underwent free uroflowmetry.

Exclusion criteria contained those with untreated urinary tract infection, uncontrolled diabetes, and those who couldn’t urinate during uroflow study.

Results: 352 women were enrolled in the study, their mean age was (46±10) years.

Clinical story showed that 85.2% of these women suffered from urinary incontinence, 20.5% had dysuria, 5.9% suffered from enuresis.

Pelvic exam showed that 33.5% had grade 1 cystocyle, 32.1% had grade 2 cystocyle, whereas 6% had grade 3 cystocyle.

Mean of residual volume was (12±56) ml.

Concerning uroflow parameters, they were as follows: voided volume (265±187) ml, Qmax(25.7±14.3)ml/sec, Qave(12.1±6.5)ml/sec, flow time (22.8±19.8) sec, time to maximum flow (8.9±11.4) sec, Qmax on Liverpool was on the line of (41.9±31)%.

There were important relations between Qmax on Liverpool and age (p=0.03), residual volume (p=0.012), story of urinary incontinence (0.035), severity of incontinence (p=0.04), story of enuresis (p=0.017), story of dysuria (p=0.001) and presence of cystocyle (p=0.013).

All of these cases had negative relations with Qmax on Liverpool.

Shapes of uroflow contained bell shapes (72.4%), and not bell shapes (27.6%) which included prolonged, intermittent, wavy and hadabie shapes.

These shapes were not affected by age, weight or number of deliveries but by residual volume (p<0.001) and by the story of dysuria (p<0.001), that (not bell shapes) were more prevalent in these cases.

Not bell shapes were also more prevalent in cases of urinary incontinence (specially pure stress incontinence), severe incontinence, story of enuresis and presence of grade 2 or 3 cystocyes, but the relationship between these cases and uroflow shapes were statistically unimportant.

On the other hand, story of dysuria in predicting voiding dysfunction (which is defined in our study as the presence of at least one of these parameters on uroflow: Qmax on Liverpool ≤10%, or residual volume ≥50 ml or presence of not bell shapes of uroflow) had a sensitivity of 0.385 and a specificity of 0.891.

Conclusions: Qmax in our study had a mean value of (41.9±31%) on Liverpool Normogram which was relatively low.

This Qmax on Liverpool had an important negative relation with age, story of urinary incontinence, severity of incontinence, story of enuresis or dysuria, presence of cystocyle, and residual volume.

Not bell shapes˜ of uroflow were more prevalent in cases of of dysuria.

In these shapes residual volume was significantly more than that in bellshape uroflows.

Not bell shapes˜ were also more prevalent in cases of urinary incontinence (specially pure stress incontinence), severe incontinence, story of enuresis and presence of cystocyes, but the relationship between these cases and uroflow shapes were statistically unimportant.

Also we found that the story of dysuria had low sensitivity and high specificity in the prediction of voiding dysfunction on uroflowmetry.