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Uroflowmetry is a medical assessment of the physical parameters of urination. Urine is an important biomaterial by which human health can be assessed. Therefore, in diseases of the genitourinary system and many other pathologies, urine tests are prescribed. But not only chemical data provide information, the speed of urination, pressure and intensity, and the frequency of urges also matter. All these parameters are measured during uroflowmetry.
What’s this
This procedure belongs to the diagnostic methods, it is absolutely painless and does not carry any risks for the patient. But uroflowmetry makes it possible to evaluate the work of the urethra, find possible problems and eliminate them. During the act of emptying the bladder, many muscles are involved, one of the most important for proper urination is the sphincter and detrusor. The first is the circular muscle, which relaxes during the urge to let the fluid out. The detrusor is a sheath of muscles that tenses and contracts, thereby creating pressure and pushing fluid into the urethra. Normally, these muscles should work together. If one of them or both function incorrectly, the act of urination is disturbed.
Such failures lead to serious violations of the normal rhythm of life. The patient may constantly feel pain and a desire to go to the toilet, while emptying is not always possible. There are situations reverse – urinary incontinence. Any of these pictures causes psychological and physical discomfort, often a person cannot work normally or just relax. It is very important to diagnose and treat such problems, and this is what uroflowmetry is for.
The method consists in the fact that the patient in the urologist’s office performs a test act of urination. It does not hurt at all, but causes difficulties and sick people due to a false sense of shame. The doctor tries to prepare and morally support the patient, since tension at this moment can affect the results of uroflowmetry. The act parameters are evaluated in two ways:
- by a hardware method, in which urine enters a special block that measures data;
- manually when using a regular stopwatch and container.
The manual method is rarely used, it is considered an outdated survey technique, as the data may be incorrect. Most often, a doctor’s office has a uroflowmeter; different devices are used for women and men. Also, the difference is in the posture when passing the test, for women, a sitting position, for men, standing. Also, such a diagnosis can be prescribed to a child, children over 3 years old go through it in the same way as adults. Toddlers under three years of age go through the process while sitting, and children up to a year lying down.
There are no difficulties other than emotional ones. The only exception is children, because it can be difficult for them to calculate the moment of urination. At the appointment, the patient performs a habitual act, the doctor evaluates the data, draws up a conclusion. Each group of the population (children, women, men) has its own norms of speed, volume, time of a full act. For comparison, the doctor has tables or graphs with the norms by which he compares the indicators.
Indications for the procedure
As an independent study, uroflowmetry is not prescribed. Most often, it is prescribed as an addition to other studies, to exclude or confirm the diagnosis. A direct indication for its implementation is any violation during the act of urination, these can be:
- A long break between the desire to empty and the beginning of the act itself. Normally, the waiting time is no more than 10 seconds; waiting too long indicates a violation in the function of the sphincter or detrusor.
- Sluggish and too long emptying indicates a weak contraction of the detrusor.
- The intensity of the flow should be the highest at the very beginning and subside towards the end of the act. If during one act there is not one peak of the jet, but two or more, this indicates inconsistent work of the muscles, disrupted work of nerve cells.
- Too intense jet for a small amount of time indicates sphincter incontinence.
- Other violations: constant urge, incontinence, small amount of urine, etc.
The cause for such phenomena may be a serious pathology or infection. For example, recurrent cystitis, benign and malignant tumors, inflammation. Often, incontinence or, conversely, urinary retention occurs with neurological disorders, psychological abnormalities after stress. Urine flow diagnostics, together with other types of analyzes and tests, help to determine the cause of failures, prevent the development of serious diseases and, most importantly, restore the patient’s health.
Such a procedure is carried out for absolutely all groups of patients, including the elderly, pregnant women, and infants. The only contraindication for uroflowmetry is a fistula in the genitourinary system. Also, against the background of serious psychological abnormalities and mental retardation, the results may be unreliable, and therefore the procedure is ineffective.
How to prepare
The main attention in the preparation is given to the emotional state of the patient. There is nothing terrible, dangerous or even shameful in this process, because uroflowmetry is a medical procedure. The doctor during the appointment of the diagnosis and before it itself consults his ward, explains why this is necessary, how it will help, why it is so important. If during the process to strain or be ashamed, the result may be distorted, and the procedure will become meaningless. Therefore, it is important to relax and calm down as much as possible.
In addition, as part of the preparation, it is recommended:
- a day before the examination, do not use diuretics, drugs for high blood pressure (calcium antagonists), antispasmodics.
- on the day of the procedure, do not take sedatives without the knowledge of the doctor to calm down. This can affect the strength of muscle contraction;
- an hour before visiting the treatment room, you need to drink a liter of plain water, you can’t drink carbonated water.
If any medications were used the day before or on the day of the procedure, this should be reported to the doctor. The test may have to be postponed for a clear result.
How is uroflowmetry performed?
The test takes place on an outpatient basis, in a urologist’s office or a special treatment room. Diagnostics is carried out by two methods: hardware and manually. The process of passing depends on the type of uroflowmetry, and the execution technique also affects the results.
Manually
Before testing, it is recommended to drink about a liter of water without gas. As soon as the patient feels the urge, the test begins. For both women and men, special containers with a measuring scale are used. The doctor will have a stopwatch, which he turns on at the very beginning of urination and at the end. All the time is divided by the volume of urine received. Such data allow you to set the average emission rate and volume. However, this method has many disadvantages, it is difficult to manually determine the peak of urination by manual diagnostics, so diagnosing problems with the sphincter and detrusor is quite difficult.
With the help of the device
For such an examination, a uroflowmeter is used. This instrument is equipped with a urine reservoir and sensors for measuring velocity and capturing peaks. The uroflowmeter has a button that the subject presses before the process, delaying urination for a few seconds. At the end of the test, the button is pressed again to end the test. The flow of urine first enters the funnel, and from there it moves through the tube into the measuring vessel. The sensor system responds to pressure, velocity and volume. The data obtained are recorded in the form of a curve or graph, and the volume of urine is added to these data. Then the doctor evaluates the results, comparing them with the norms.
This technique is considered more progressive, besides it has a significant plus. During the procedure, the patient can be left alone in the office if he feels very embarrassed. This gives more accurate results because the person is relaxed. On the resulting graph, you can see the onset or absence of peaks, their number, jet discontinuity. Thus, the doctor receives all the necessary information to evaluate the function of the urinary system.
Results of the study
The interpretation of the results contains several important indicators by which they can detect the disease or refute the previously diagnosed diagnosis. The analysis shows the following data:
- Waiting time. This is the period of time that is needed to wait from feeling the urge to start urinating. Normally, this figure is 10 seconds, but due to the fact that the patient may be embarrassed, this time is increased to 40 seconds. A very long interval indicates a disturbed work of the detrusor.
- Overall volume. The norm is 200-500 ml for an adult, but a smaller amount of urine does not yet indicate problems. Various deviations are diagnosed when the volume does not correspond to the emptying rate.
- Speed. In this case, a distinction is made between maximum and average speed; in pathological conditions, the maximum may not occur at all. If the maximum speed is too low, a sphincter disorder is suspected, and if it is too high, neurological problems are suspected. The time it takes to reach the maximum speed also matters.
The patient’s condition is assessed according to these data and according to the schedule. Normally, the curve resembles a bell, with a rise, a peak, a fall, and a straight line at the end. With violations of the function of the urethra, several peaks are observed, which indicates inconsistent work of the muscles. Also, the “bell” may be too long, resembling a plateau instead of a pronounced elevation. This suggests that the speed practically does not change during the process, with such a picture, urethral stricture is suspected. A peak that is too steep and an increased flow rate may indicate sphincter deficiency.
In the course of such an examination, enuresis can be diagnosed in children and adults, the data will show the cause of enuresis: organic or neurological. Neurogenic or hyperactive bladder, changes in the anatomy of the urinary system organs are also determined. The graph data, which are very different from the norm, may indicate prostatitis, tumors. To clarify the diagnosis, the doctor prescribes additional studies and tests, and then selects the tactics of treatment.
You can do such a test in public clinics, where the service is free, or in private ones. The cost of analysis in a private clinic will be 20-30 dollars. Such an examination is carried out even for pregnant women and young children, since the analysis does not affect the patient’s condition. Uroflowmetry is absolutely not a terrible and safe technique that allows you to assess the state of the genitourinary system and restore the patient’s health in the future.