Uroflowmetria

Uroflowmetric examination is performed in order to assess the urine stream and detect possible abnormalities in voiding, i.e. its passing. During uroflowmetry, the volume of excreted urine and residual urine as well as the urine flow rate are checked, among other things. In addition, the shape of the voiding curve is assessed. Uroflowmetry is one of the painless and non-invasive diagnostic techniques used in the diagnosis of urinary tract diseases. In this article, you will learn what exactly this test is about, how it is carried out, what are the indications and contraindications for its performance. In addition, you will get general information about the three-stage urodynamic test, which includes, among others, uroflowmetry.

Uroflowmetry – what is it?

The urinary tubular examination, which is uroflowmetry, is one of the three stages of urodynamic examination, next to cystometry and profilometry. Before performing the examination, the physician should take a detailed interview taking into account the patient’s current problems and diseases that hinder their proper daily functioning. Possible urinary tract infection should be ruled out. It is useful if the person who is to undergo the test keeps a diary of micturition for several days before uroflowmetry. It records information such as the amount of fluids consumed during the day, the time of urination, the amount of urine released into the toilet, as well as various notes to help the doctor diagnose the problem. These include episodes of urinary incontinence (with or without pressure), postures and activities where uncontrolled micturition occurs. We can find a paper form of the diary on the Internet, then print it and fill it in meticulously. It is a good idea to have a diary with you during uroflowmetry.

The test involves urinating into a special device – a uroflowmeter. It should be as close to natural voiding as possible, therefore the patient should be provided with peace, intimacy and the possibility of taking a comfortable and most natural position. You should come to the uroflowmetry examination with a full bladder. You need to pass 125 to 150 ml of urine. During its execution, a micturition curve is drawn on the computer screen and the parameters allowing for the detection of abnormalities are calculated. Uroflowmetry is painless and does not last long (about 10 minutes). It should be performed by an experienced urologist who will correctly interpret the obtained results, combine them with a medical history and physical examination, and provide the patient with further advice and refer him to more detailed examinations.

An abnormal uroflowmetric test result may indicate a bladder obstruction, bladder depression, urination disorders, weakening of the internal sphincter muscle in the urethra, or an abnormal overactive bladder detrusor function.

Uroflowmetry – indications and contraindications

The indications for the examination are urinary tract complaints: difficulties in emptying the bladder, difficulties in starting urination, a feeling of residual urine, sudden urgency to urinate, pollakiuria, recurrent urinary tract infections, as well as bladder diverticula. There aren’t many reasons why this screening test is out of the question. These include urinary tract infections or menstrual bleeding.

Urodynamic examination – cystometry and tubular profilometry

A comprehensive urodynamic examination is performed for the purpose of specialized diagnostics of the urinary tract. The first stage of urodynamic examination is uroflowmetry performed in the evaluation of voiding. The second step is invasive cystometry, which examines the filling and emptying phases of the bladder, and the collection and retention of urine in the bladder using two- or three-channel intravesical catheters, a rectal catheter, and electrodes pinned close to the sphincter muscles. During the examination, parameters such as intra-abdominal pressure and intravesical pressure, as well as the detrusor pressure calculated from them, are also assessed. Additionally, the activity of the pelvic floor muscles is checked. During cystometry, the patient should sit in a reclining position in a chair and will be asked to perform the Valsalva test (abdominal pressure) and the cough test. The examination takes about an hour and is performed under local anesthesia.

Urethral profilometry, the third step of the urodynamic test, examines the maximum pressure in the urethra and inside the bladder. Additionally, it measures the length of the urethra. As with cystometry, catheters are used for profilometry. The test allows to detect possible damage to the urethral sphincter.

A thorough and comprehensive evaluation of the urinary tract qualifies the patient for further treatment. Urodynamic examination is reimbursed by the National Health Fund, and referral can be obtained mainly from a gynecologist.

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