OBJECTIVE: To evaluate uroflow measurements in the initial management of lower urinary tract dysfunction in children and adolescents with cerebral palsy.
MATERIALS AND 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.
Fernandes Silva JA, Borges Carrerette F, Damião R. Are you the author?
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.
Reference: J Pediatr Urol. 2013 Aug 8. pii: S1477-5131(13)00182-4.