Urology Unit - Schneider Children's Medical Center of Israel, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Petach Tikva, Tel Aviv, 4941492, Israel.
BMC Urol. 2024 Sep 6;24(1):196. doi: 10.1186/s12894-024-01575-9.
To evaluate the effect of urethral catheterization on the accuracy of EMG uroflowmetry in children with non-neurogenic voiding disorders during pressure-flow (PF) studies compared to the non-invasive EMG uroflowmetry test.
A retrospective study of children undergoing a urodynamic evaluation at our institution between 8/2018 and 7/2022 was employed. Urination curves and pelvic floor muscle activity were compared between PF studies and non-invasive EMG uroflowmetry test. The non-invasive test was selected as the standard benchmark.
104 children were tested, with 34 children (33%) being able to urinate only in a non-invasive EMG uroflowmetry. The percentage of boys unable to urinate with a catheter was significantly higher than girls (54% vs. 13%, p-value < 0.001). In 70 children, a normal bell-shaped urination curve was found in 13 compared to 33 children in the PF studies and non-invasive uroflowmetry, respectively. PF studies demonstrated a specificity of 39% (95% CI 23-57) and a positive predictive value (PPV) of 61% (95% CI 53-67) in finding non-bell-shaped curves. Relaxation of pelvic muscles was found in 21 (30%) as opposed to 39 (55%) of children in invasive and non-invasive EMG uroflowmetry, respectively (p-value = 0.5).
The accuracy of PF studies in children, primarily in boys, compared to the non-invasive uroflowmetry, was poor. This may pose potential errors in diagnosis and subsequent treatment. We recommend completing a non-invasive EMG uroflowmetry in cases where the child refused to urinate, or pathology was found, requiring a modification in treatment.
评估在压力-流（PF）研究中与非侵入性 EMG 尿流率测试相比，导尿对非神经源性排尿障碍儿童 EMG 尿流率测量准确性的影响。
对 2018 年 8 月至 2022 年 7 月期间在我院进行尿动力学评估的儿童进行回顾性研究。比较 PF 研究和非侵入性 EMG 尿流率测试的排尿曲线和盆底肌活动。选择非侵入性测试作为标准基准。
共测试了 104 名儿童，其中 34 名（33%）只能在非侵入性 EMG 尿流率测试中排尿。不能用导管排尿的男孩比例明显高于女孩（54%比 13%，p 值<0.001）。在 70 名儿童中，与 PF 研究和非侵入性尿流率测试中分别有 13 名和 33 名儿童相比，70 名儿童的排尿曲线呈正常钟形。PF 研究在发现非钟形曲线方面的特异性为 39%（95%CI 23-57），阳性预测值（PPV）为 61%（95%CI 53-67）。与侵入性和非侵入性 EMG 尿流率测试中分别有 39 名（55%）和 21 名（30%）的儿童相比，发现盆底肌肉放松（p 值=0.5）。
与非侵入性尿流率测试相比，PF 研究在儿童中的准确性较差，尤其是在男孩中。这可能会导致诊断和随后治疗的潜在错误。我们建议在儿童拒绝排尿或发现需要改变治疗方案的病理时，完成非侵入性 EMG 尿流率测试。
