Free video uroflowmetry and its application in evaluating lower urinary tract dysfunction in children

Wu G1, Wu R1, Li H1, Wen J2

Research Type

Clinical

Abstract Category

Paediatrics

Abstract 545
Open Discussion ePosters
Scientific Open Discussion Session 105
Friday 19th September 2025
13:30 - 13:35 (ePoster Station 2)
Exhibition
Pediatrics Voiding Dysfunction Urodynamics Techniques Urgency/Frequency Nocturnal Enuresis
1. Department of Urology, Dongguan Children Hospital , China, 2. Pediatric Urology, Department of Urology, First Affiliated Hospital of Zhengzhou University, China
Presenter
Links

Abstract

Hypothesis / aims of study
This is an original research on the application of free video uroflowmetry (FVU)  in evaluating lower urinary tract dysfunction (LUTD) in children.  Free uroflowmetry, performed without catheter in urethra, is commonly used for screening LUTD in children,but lacks visualization of bladder-urethral morphology and vesicoureteral reflux (VUR). Video urodynamic study (VUR) covers these, but urethral catheters in site may induce artifact. To overcome these shortcoming, we performed FVU to evaluate its feasibility and role in evaluating LUTD in children.
Study design, materials and methods
Retrospective analysis was performed in children with LUTD at Dongguan Children's Hospital between Sep.2024 and Feb 2025. The cases was divided into 3 groups: free uroflowmetry group (FU), video urodynamics group (VU), and FVU group. Parameters collected including maximum flow rate (Qmax), average flow rate (Qave), voiding-time, voided-volume, post-void residual urine(PVR)) and imaging findings [VUR, detrusor-sphincter dyssynergia (DSD), pseudo-residual urine]. Pseudo-residual urine refers to refluxed urine returning to the bladder after complete voiding. Instilling contrast into bladder agent via transurethral catheterj and then removel catheter before FVU, which is performe under C-arm fluoroscopyr. Statistical analysis used ANOVA, chi-square tests, and paired t-tests, with significance set at P < 0.05.
Results
Documents collected from 26 children (15 male, 11 female; mean age 7.96±2.67 years) qualified for analysis, including severe enuresis (n=13), non-neurogenic neurogenic bladder (n=7), neurogenic bladder (n=3), urgency incontinence (n=2), and bladder-bowel dysfunction (n=1). Three children were unable to void due to urethral pain during VUD. Both FU and FVU showed significant differences compared to VU in Qmax, Qave, voiding-time, and PVR (P < 0.05) (Table1). Imaging findings showed no significant difference between FVU (16/26) and VU (17/26) (P > 0.05) (Table2).
Interpretation of results
In this study, 11.5% of children were unable to void during VU with catheter in urethra. Significant differences in Qmax, Qave, voiding-time, and PVR were observed between FU and FVU compared to VU, indicating that urethral catheter significantly impacts the voiding function. Furthermore, the absence of significant differences in imaging findings between the FVU and VU suggesting that FVU ia able to show bladder-urethral morphology and he presence or absence of VUR. Cosidering FVU is more close to a physiological state to show voiding function, it serves as a more valuable complement to conventional FU and VU in pediatric LUTD evaluation in children.
Concluding message
FVU is a useful tool to evaluate LUTD in children, not only show the parameters collected from FU but also visualizing anatomical abnormalities and VUR.
Figure 1 Table1. Uroflowmetry parameters in 3 groups
Figure 2 Table2: Imaging findings in VU and FVU
References
  1. Bercovich S, Morag R, Sivan B, Ben Meir D. A comparative study between EMG uroflowmetry with and without a catheter in children. BMC Urol. 2024 Sep 6;24(1):196
  2. Neri DA, Venturini BA, Massuqueto E, Estevam de Abreu G, Portugal MM, Costa J, Velame Souza Santos MK, de Araújo Rosier C, Monteiro G, Barroso U Jr. Agreement between two uroflowmetry tests in children with lower urinary tract symptoms. J Pediatr Urol. 2025 Apr;21(2):296-302.
  3. ang S, Zhou Z, Yang J, Pu Q, Wen Y, Liu X, Zhang Y, Lv L, Hu J, Franco I, Kamperis K, Rittig S, Wang Q, Wen JG. The value of home-uroflowmetry in evaluation of voiding function in children with overactive bladder. J Pediatr Urol. 2025 Apr;21(2):289-295.
Disclosures
Funding National Natural Science Foundation of China(82470807,82470806) Clinical Trial No Subjects Human Ethics Committee Ethics Committee of Dongguan Children Hospital,China Helsinki Yes Informed Consent Yes
07/07/2025 09:16:02