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Evaluation of bladder capacity in children with lower urinary tract symptoms: Comparison of 48-hour frequency/volume charts and uroflowmetry measurements.
J Pediatr Urol. 2016 Aug; 12(4):214.e1-5.JP

Abstract

INTRODUCTION

Objective evaluation of bladder capacity (BC) in children with lower urinary tract symptoms (LUTS) is important for recognizing types of bladder dysfunction. Bladder capacity is evaluated from 48-hour frequency/volume (48-h F/V) charts or by uroflowmetry with ultrasound post-void assessment. There are limited data on the reliability of both methods of assessment in children.

OBJECTIVE

The aim of the study was to compare two modalities of assessment, (F/V chart and uroflowmetry) in cohorts of children with bladder dysfunctions.

STUDY DESIGN

Maximum bladder capacity (MBC) obtained from 48-h F/V charts was compared with volumes calculated from uroflowmetry in a cohort of 86 children with different bladder dysfunctions. The BC obtained by the two modalities was compared for the three most frequent subtypes of bladder dysfunction: monosymptomatic nocturnal enuresis (MNE), overactive bladder (OAB), and dysfunctional voiding (DV). Considering a 48-h F/V chart as standard, the sensitivity, specificity, negative and positive predictive values of uroflowmetry measurements were calculated for detecting low bladder capacity.

RESULTS

The mean maximal bladder capacity (188 ± 99.42 ml) obtained from home 48-h F/V chart measurement was 17 ml lower than the mean value obtained from uroflowmetry (205 ± 112.11 ml) (P = 0.58). The differences between bladder capacities estimated by 48-h F/V chart and uroflowmetry for subjects were not significant (Figure). Concordance between 48-h F/V chart and uroflowmetry categorization of BC was present in 64 (74%) subjects. The sensitivity and specificity of uroflowmetry, in comparison with 48-h F/V chart evaluation, for recognizing low bladder capacity were 75.5% and 73.17%. The sensitivity and specificity for the different types of LUTS achieved 68.42% and 58.83% for OAB, 80% and 83% for MNE, and 50% and 83.3% for DV.

DISCUSSION

According to the International Children's Continence Society, the management of MNE in children can be made without uroflowmetry. History and MBC evaluation by 48-h F/V charts yields sufficient information. Nevertheless, in situations where F/V charts are unreliable or unavailable, uroflowmetry can be used as an alternative method. The highest discrepancy between both methods of BC evaluation was found in DV; this was mainly due to the mean PVR of 31 ml.

CONCLUSION

For children with MNE, both 48-hour frequency/volume charts and triplicate urine flow measurement with PVR evaluation are reliable methods of maximum bladder capacity evaluation. For children with OAB or DV, both methods may be necessary for accurate evaluation of decreased BC, as F/V chart and uroflow results may not be comparable.

Authors+Show Affiliations

Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, ul. Dębinki 7, Gdansk 80-952, Poland. Electronic address: mmaternik@gumed.edu.pl.Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, ul. Dębinki 7, Gdansk 80-952, Poland.Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, ul. Dębinki 7, Gdansk 80-952, Poland.Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, ul. Dębinki 7, Gdansk 80-952, Poland.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27329866

Citation

Maternik, M, et al. "Evaluation of Bladder Capacity in Children With Lower Urinary Tract Symptoms: Comparison of 48-hour Frequency/volume Charts and Uroflowmetry Measurements." Journal of Pediatric Urology, vol. 12, no. 4, 2016, pp. 214.e1-5.
Maternik M, Chudzik I, Krzeminska K, et al. Evaluation of bladder capacity in children with lower urinary tract symptoms: Comparison of 48-hour frequency/volume charts and uroflowmetry measurements. J Pediatr Urol. 2016;12(4):214.e1-5.
Maternik, M., Chudzik, I., Krzeminska, K., & Żurowska, A. (2016). Evaluation of bladder capacity in children with lower urinary tract symptoms: Comparison of 48-hour frequency/volume charts and uroflowmetry measurements. Journal of Pediatric Urology, 12(4), e1-5. https://doi.org/10.1016/j.jpurol.2016.04.004
Maternik M, et al. Evaluation of Bladder Capacity in Children With Lower Urinary Tract Symptoms: Comparison of 48-hour Frequency/volume Charts and Uroflowmetry Measurements. J Pediatr Urol. 2016;12(4):214.e1-5. PubMed PMID: 27329866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of bladder capacity in children with lower urinary tract symptoms: Comparison of 48-hour frequency/volume charts and uroflowmetry measurements. AU - Maternik,M, AU - Chudzik,I, AU - Krzeminska,K, AU - Żurowska,A, Y1 - 2016/05/07/ PY - 2015/12/31/received PY - 2016/04/29/accepted PY - 2016/6/23/entrez PY - 2016/6/23/pubmed PY - 2017/4/21/medline KW - 48-Hour frequency/volume chart KW - Bladder capacity KW - Lower urinary tract symptoms KW - Pediatrics KW - Uroflowmetry SP - 214.e1 EP - 5 JF - Journal of pediatric urology JO - J Pediatr Urol VL - 12 IS - 4 N2 - INTRODUCTION: Objective evaluation of bladder capacity (BC) in children with lower urinary tract symptoms (LUTS) is important for recognizing types of bladder dysfunction. Bladder capacity is evaluated from 48-hour frequency/volume (48-h F/V) charts or by uroflowmetry with ultrasound post-void assessment. There are limited data on the reliability of both methods of assessment in children. OBJECTIVE: The aim of the study was to compare two modalities of assessment, (F/V chart and uroflowmetry) in cohorts of children with bladder dysfunctions. STUDY DESIGN: Maximum bladder capacity (MBC) obtained from 48-h F/V charts was compared with volumes calculated from uroflowmetry in a cohort of 86 children with different bladder dysfunctions. The BC obtained by the two modalities was compared for the three most frequent subtypes of bladder dysfunction: monosymptomatic nocturnal enuresis (MNE), overactive bladder (OAB), and dysfunctional voiding (DV). Considering a 48-h F/V chart as standard, the sensitivity, specificity, negative and positive predictive values of uroflowmetry measurements were calculated for detecting low bladder capacity. RESULTS: The mean maximal bladder capacity (188 ± 99.42 ml) obtained from home 48-h F/V chart measurement was 17 ml lower than the mean value obtained from uroflowmetry (205 ± 112.11 ml) (P = 0.58). The differences between bladder capacities estimated by 48-h F/V chart and uroflowmetry for subjects were not significant (Figure). Concordance between 48-h F/V chart and uroflowmetry categorization of BC was present in 64 (74%) subjects. The sensitivity and specificity of uroflowmetry, in comparison with 48-h F/V chart evaluation, for recognizing low bladder capacity were 75.5% and 73.17%. The sensitivity and specificity for the different types of LUTS achieved 68.42% and 58.83% for OAB, 80% and 83% for MNE, and 50% and 83.3% for DV. DISCUSSION: According to the International Children's Continence Society, the management of MNE in children can be made without uroflowmetry. History and MBC evaluation by 48-h F/V charts yields sufficient information. Nevertheless, in situations where F/V charts are unreliable or unavailable, uroflowmetry can be used as an alternative method. The highest discrepancy between both methods of BC evaluation was found in DV; this was mainly due to the mean PVR of 31 ml. CONCLUSION: For children with MNE, both 48-hour frequency/volume charts and triplicate urine flow measurement with PVR evaluation are reliable methods of maximum bladder capacity evaluation. For children with OAB or DV, both methods may be necessary for accurate evaluation of decreased BC, as F/V chart and uroflow results may not be comparable. SN - 1873-4898 UR - https://www.unboundmedicine.com/medline/citation/27329866/Evaluation_of_bladder_capacity_in_children_with_lower_urinary_tract_symptoms:_Comparison_of_48_hour_frequency/volume_charts_and_uroflowmetry_measurements_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-5131(16)30028-6 DB - PRIME DP - Unbound Medicine ER -