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Published in: International Urogynecology Journal 7/2008

01-07-2008 | Current Opinion / Update

Uroflowmetry: its current clinical utility for women

Authors: Bernard T. Haylen, Vivian Yang, Vanessa Logan

Published in: International Urogynecology Journal | Issue 7/2008

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Abstract

Uroflowmetry, the simple, non-invasive measurement of urine flow over time during micturition, has a long and interesting history, clear definitions, a clear purpose in screening for voiding difficulty and, most importantly, technical accuracy. Data interpretation is currently limiting its clinical utility, despite appropriate analysis being available in long-standing existing research. The main clinically important numerical parameters are the maximum and average urine flow rates and the voided volume. Urine flow rates are strongly dependent on voided volume. Reference to established (Liverpool) nomograms will most accurately correct for this dependency. Nomograms will also optimise the validation of uroflowmetry data and the accurate assessment of its normality, compared with fixed urine flow rates and “cutoffs” for voided volume. Abnormally slow urine flow (under the 10th centile Liverpool Nomograms) is the most clinically significant abnormality. Repeat uroflowmetry, concomitant post-void residual measurement and voiding cystometry studies are appropriate options for evaluating any abnormal uroflowmetry.
Literature
1.
go back to reference Rehfisch E (1897) Ueber den mechanismus des harnblasenverschlusses under der harnentkerung. Virchow Arch Path Anat 150:1111–1151 Rehfisch E (1897) Ueber den mechanismus des harnblasenverschlusses under der harnentkerung. Virchow Arch Path Anat 150:1111–1151
3.
go back to reference Gronwell H (1925) Blastomningens mechanism. Sven Lakartidn 22:577 Gronwell H (1925) Blastomningens mechanism. Sven Lakartidn 22:577
4.
go back to reference Drake WM Jr (1948) The uroflowmeter: an aid to the study of the urinary tract. J Urol 59:650–658PubMed Drake WM Jr (1948) The uroflowmeter: an aid to the study of the urinary tract. J Urol 59:650–658PubMed
5.
go back to reference Von Garrelts B (1956) Analysis of micturition. A new method of recording the voiding of the bladder. Acta Chir Scand 112:326–340 Von Garrelts B (1956) Analysis of micturition. A new method of recording the voiding of the bladder. Acta Chir Scand 112:326–340
6.
go back to reference Rowan D, McKenzie AL, McNee SG, Glen ES (1977) A technical and clinical evaluation of the Disa uroflowmeter. Brit J Urol 49:285–293PubMed Rowan D, McKenzie AL, McNee SG, Glen ES (1977) A technical and clinical evaluation of the Disa uroflowmeter. Brit J Urol 49:285–293PubMed
7.
go back to reference Peter WP, Drake WM Jr (1958) Uroflowmetric observations in gynaecologic patients. JAMA 166:721–724 Peter WP, Drake WM Jr (1958) Uroflowmetric observations in gynaecologic patients. JAMA 166:721–724
8.
go back to reference Farrar DJ, Osborne JL (1984) Voiding dysfunction in women. In: Mundy AR, Stephensen TP, Wein AJ (eds) Urodynamics: principles, practice and application, chapter 23. Churchill Livingstone, Edinburgh, pp 242–248 Farrar DJ, Osborne JL (1984) Voiding dysfunction in women. In: Mundy AR, Stephensen TP, Wein AJ (eds) Urodynamics: principles, practice and application, chapter 23. Churchill Livingstone, Edinburgh, pp 242–248
9.
go back to reference Bergman A, Bhatia NN (1985) Uroflowmetry for predicting postoperative voiding difficulties in women with stress urinary incontinence. Brit J Obstet Gynaecol 92:835–838 Bergman A, Bhatia NN (1985) Uroflowmetry for predicting postoperative voiding difficulties in women with stress urinary incontinence. Brit J Obstet Gynaecol 92:835–838
10.
go back to reference Axelrod SL, Blaivas JG (1987) Bladder neck obstruction in women. J Urol 137:497–499PubMed Axelrod SL, Blaivas JG (1987) Bladder neck obstruction in women. J Urol 137:497–499PubMed
11.
go back to reference Torrens MJ (1987) Urodynamics. In: Torrens MJ (ed) The physiology of the lower urinary tract, chapter 9. Springer, Berlin, pp 277–307 Torrens MJ (1987) Urodynamics. In: Torrens MJ (ed) The physiology of the lower urinary tract, chapter 9. Springer, Berlin, pp 277–307
12.
go back to reference Bates P, Glen ES, Griffiths D, for the International Continence Society et al (1977) Second report on the standardization of terminology of lower urinary tract function, procedures related to the evaluation of micturition—flow rate, pressure measurement, symbols. Scand J Urol Nephrol 11:197–199CrossRef Bates P, Glen ES, Griffiths D, for the International Continence Society et al (1977) Second report on the standardization of terminology of lower urinary tract function, procedures related to the evaluation of micturition—flow rate, pressure measurement, symbols. Scand J Urol Nephrol 11:197–199CrossRef
14.
go back to reference Wyndaele J-JJM (2006) Uroflowmetry. In: Cardozo LD, Staskin D (eds) Textbook of female urology and urogynecology. Informa Healthcare, Oxford, pp 216–221 Wyndaele J-JJM (2006) Uroflowmetry. In: Cardozo LD, Staskin D (eds) Textbook of female urology and urogynecology. Informa Healthcare, Oxford, pp 216–221
15.
go back to reference Nitti VW, Fischer MC (2008) Urodynamics. In: Bent AE, Cundiff GW, Swift SE (eds) Urogynecology and pelvic floor dysfunction. Lippincott, Williams and Wilkins, Philadelphia, p 79 Nitti VW, Fischer MC (2008) Urodynamics. In: Bent AE, Cundiff GW, Swift SE (eds) Urogynecology and pelvic floor dysfunction. Lippincott, Williams and Wilkins, Philadelphia, p 79
16.
go back to reference Moore KH, Richmond DH, Sutherst JR et al (1991) Crouching over a toilet seat: prevalence amongst British gynaecological outpatients and its effect on micturition. Brit J Urol 98:569–572 Moore KH, Richmond DH, Sutherst JR et al (1991) Crouching over a toilet seat: prevalence amongst British gynaecological outpatients and its effect on micturition. Brit J Urol 98:569–572
17.
go back to reference Massey JA, Abrams PH (1988) Obstructed voiding in the female. Brit J Urol 61:36–39PubMed Massey JA, Abrams PH (1988) Obstructed voiding in the female. Brit J Urol 61:36–39PubMed
18.
go back to reference Fantl JA, Smith PJ, Schneider V et al (1982) Fluid weight uroflowmetry in women. Am J Obstet Gynecol 145:1017–1024 Fantl JA, Smith PJ, Schneider V et al (1982) Fluid weight uroflowmetry in women. Am J Obstet Gynecol 145:1017–1024
19.
go back to reference Costantini E, Mearini E, Pajoncini C et al (2003) Uroflowmetry in female voiding disturbances. Neurourol Urodyn 22:569–573PubMedCrossRef Costantini E, Mearini E, Pajoncini C et al (2003) Uroflowmetry in female voiding disturbances. Neurourol Urodyn 22:569–573PubMedCrossRef
20.
go back to reference Fantl JA (1984) Clinical uroflowmetry. In: Ostergard DR (ed) Gynecologic urology and urodynamics: theory and practice, chapter 11. 2nd edn. Williams and Wilkins, Baltimore, pp 125–132 Fantl JA (1984) Clinical uroflowmetry. In: Ostergard DR (ed) Gynecologic urology and urodynamics: theory and practice, chapter 11. 2nd edn. Williams and Wilkins, Baltimore, pp 125–132
21.
go back to reference Haylen BT, Ashby D, Sutherst JR et al (1989) Maximum and average urine flow rates in normal male and female populations—the Liverpool Nomograms. Brit J Urol 64:30–38PubMedCrossRef Haylen BT, Ashby D, Sutherst JR et al (1989) Maximum and average urine flow rates in normal male and female populations—the Liverpool Nomograms. Brit J Urol 64:30–38PubMedCrossRef
22.
go back to reference Haylen BT, Law MG, Frazer MI, Schulz S (1999) Urine flow rates and residual urine volumes in urogynaecology patients. Int Urogynecol J 6:378–383CrossRef Haylen BT, Law MG, Frazer MI, Schulz S (1999) Urine flow rates and residual urine volumes in urogynaecology patients. Int Urogynecol J 6:378–383CrossRef
23.
go back to reference Haylen BT, Parys BT, Anyaegbunam WI, Ashby D (1990) Urine flow rates in male and female urodynamic patients compared with the Liverpool Nomograms. Brit J Urol. 65:483–487PubMed Haylen BT, Parys BT, Anyaegbunam WI, Ashby D (1990) Urine flow rates in male and female urodynamic patients compared with the Liverpool Nomograms. Brit J Urol. 65:483–487PubMed
24.
go back to reference Ryall RL, Marshall VR (1982a) Normal peak urinary flow rate obtained from small voided volumes can provide a reliable assessment of bladder function. J Urol 127:484–487PubMed Ryall RL, Marshall VR (1982a) Normal peak urinary flow rate obtained from small voided volumes can provide a reliable assessment of bladder function. J Urol 127:484–487PubMed
25.
go back to reference Groutz A, Blaivas JG, Chaiken DC (2000) Bladder outflow obstruction in women: definition and characteristics. Neurourol Urodyn 19:213–220PubMedCrossRef Groutz A, Blaivas JG, Chaiken DC (2000) Bladder outflow obstruction in women: definition and characteristics. Neurourol Urodyn 19:213–220PubMedCrossRef
26.
go back to reference Dawson T, Lawton V, Adams E, Richmond D (2007) Factors predictive of post-TVT voiding dysfunction. Int Urogynecol J 18:1297–1302CrossRef Dawson T, Lawton V, Adams E, Richmond D (2007) Factors predictive of post-TVT voiding dysfunction. Int Urogynecol J 18:1297–1302CrossRef
27.
go back to reference Bottacini MR, Gleason DJ (1980) Urodynamic norms in women: normals vs stress incontinents. J Urol 124:659–661 Bottacini MR, Gleason DJ (1980) Urodynamic norms in women: normals vs stress incontinents. J Urol 124:659–661
28.
go back to reference Haylen BT, Krishnan S, Schulz S et al (2007) Has the true prevalence of voiding difficulty in urogynecology patients been underestimated? Int Urogynecol J 18:53–56CrossRef Haylen BT, Krishnan S, Schulz S et al (2007) Has the true prevalence of voiding difficulty in urogynecology patients been underestimated? Int Urogynecol J 18:53–56CrossRef
29.
30.
go back to reference Ryall RL, Marshall VR (1982) The effect of a urinary catheter on the measurement of maximum urine flow rate. J Urol 128:429–432PubMed Ryall RL, Marshall VR (1982) The effect of a urinary catheter on the measurement of maximum urine flow rate. J Urol 128:429–432PubMed
Metadata
Title
Uroflowmetry: its current clinical utility for women
Authors
Bernard T. Haylen
Vivian Yang
Vanessa Logan
Publication date
01-07-2008
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 7/2008
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-008-0597-8

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