PURPOSE: To investigate the correlation between subjective (clinical) treatment outcome and objective uroflowmetry parameters and curve pattern in children with dysfunctional voiding. METHOD: Seventy-five children were randomly allocated to two urotherapy programs. Group A was submitted to standard urotherapy and pelvic floor exercises while group B received conservative treatment. Constipation and recurrent urinary tract infections (UTIs) were treated in both groups. Selected children from both groups received pharmacotherapy (anticholinergics or desmopressin). Uroflowmetry with electromyography of the pelvic floor and ultrasound post-void residual (PVR) urine volumes were obtained before and at the end of the 12-month treatment period. Uroflowmetry findings were stratified into two categories based on clinical treatment outcome: 'cured' and 'unchanged'. Uroflowmetry findings were compared between categories at the beginning and the end of the investigation. RESULTS:Voided volume, average and peak flow rates were significantly increased while PVR urine was decreased in children with cured urinary incontinence and nocturnal enuresis compared with 'unchanged' category. Significant decrease of PVR urine was noted in children with cured UTIs. The frequency of a bell-shaped curve was significantly higher compared to other curve patterns in children with cured urinary incontinence and UTIs. CONCLUSION: Post-treatment improvement in clinical symptoms correlated with improvement in uroflowmetry parameters and curve pattern. Correction of voiding phase is necessary for urinary continence achievement and resolution of UTIs. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
RCT Entities:
PURPOSE: To investigate the correlation between subjective (clinical) treatment outcome and objective uroflowmetry parameters and curve pattern in children with dysfunctional voiding. METHOD: Seventy-five children were randomly allocated to two urotherapy programs. Group A was submitted to standard urotherapy and pelvic floor exercises while group B received conservative treatment. Constipation and recurrent urinary tract infections (UTIs) were treated in both groups. Selected children from both groups received pharmacotherapy (anticholinergics or desmopressin). Uroflowmetry with electromyography of the pelvic floor and ultrasound post-void residual (PVR) urine volumes were obtained before and at the end of the 12-month treatment period. Uroflowmetry findings were stratified into two categories based on clinical treatment outcome: 'cured' and 'unchanged'. Uroflowmetry findings were compared between categories at the beginning and the end of the investigation. RESULTS: Voided volume, average and peak flow rates were significantly increased while PVR urine was decreased in children with cured urinary incontinence and nocturnal enuresis compared with 'unchanged' category. Significant decrease of PVR urine was noted in children with cured UTIs. The frequency of a bell-shaped curve was significantly higher compared to other curve patterns in children with cured urinary incontinence and UTIs. CONCLUSION: Post-treatment improvement in clinical symptoms correlated with improvement in uroflowmetry parameters and curve pattern. Correction of voiding phase is necessary for urinary continence achievement and resolution of UTIs. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.