Portal de Periódicos da CAPES

Interpretation of Uroflowmetry Curves by Urologists

1997; Lippincott Williams & Wilkins; Volume: 157; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(01)65314-x

1527-3792

C. van de Beek, Herman Stoevelaar, J. McDonnell, H. G. T. Nijs, A. F. Casparie, R.A. Janknegt,

Urinary Tract Infections Management

No AccessJournal of UrologyClinical Urology: Original Article1 Jan 1997Interpretation of Uroflowmetry Curves by Urologists C. Van De Beek, H.J. Stoevelaar, J. McDonnell, H.G.T. Nijs, A.F. Casparie, and R.A. Janknegt C. Van De BeekC. Van De Beek , H.J. StoevelaarH.J. Stoevelaar , J. McDonnellJ. McDonnell , H.G.T. NijsH.G.T. Nijs , A.F. CasparieA.F. Casparie , and R.A. JanknegtR.A. Janknegt View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65314-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Uroflowmetry has become a routine investigation in patients with symptoms of the lower urinary tract. Little is known about the variation in the use of uroflowmetry and in the interpretation of its outcomes. We investigated the diagnostic value of uroflowmetry as a freestanding test, and examined the interobserver and intra-observer variation in the interpretation of uroflowmetry curves. Materials and Methods: A representative panel of 58 urologists was questioned about the relevance of visual inspection and flow parameters for interpretation. In addition, they individually assessed 25 randomly selected uroflowmetry curves (from patients with no abnormalities and those with various lower urinary tract symptoms) regarding normal findings and the most likely diagnosis. To investigate intra-observer agreement 4 of these curves were studied twice. Results: Voided volume (81%), visual inspection (77%) and maximum flow rate (77%) were most frequently mentioned as relevant for interpretation. Large differences existed between panel opinions and actual case information. For 43% of the normal cases the panel members considered the curves as abnormal. Of the abnormal cases 6% of the curves were regarded as normal. The urologists predicted correctly the actual diagnosis in 36% of all cases. Interobserver agreement was moderate for normalcy (kappa 0.46, standard error 0.087) and poor for the most likely diagnosis (kappa 0.30, standard error 0.043). Intra-observer agreement was also not satisfactory. On average, for the 4 cases studied twice 29% of the panel members chose another option for normalcy, while 41% mentioned another diagnosis the second time. Conclusions: These results necessitate reconsideration of the diagnostic use of uroflowmetry in daily urological practice. References 1 Benign Prostatic Hyperplasia Guideline Panel: Benign Prostatic Hyperplasia: Diagnosis and Treatment. Rockville, Maryland: United States Department of Health and Human Services1994. Google Scholar 2 : Proceedings of the 2nd International Consultation on Benign Prostatic Hyperplasia (BPH). Jersey, Channel Islands: Scientific Communication International1993. Google Scholar 3 : Variation in the diagnosis and treatment of benign prostatic hyperplasia in urological practice.. Ned. Tijdschr. Geneeskd.1996; 140: 837. Google Scholar 4 : Uroflowmetry. In: Clinical Neurourology. Edited by . Boston: Little, Brown & Co.1991: 201. chapt. 11. Google Scholar 5 : Variability and circadian changes in home uroflowmetry in patients with benign prostatic hyperplasia compared to normal controls.. J. Urol.1992; 147: 1044. Abstract, Google Scholar 6 : The flow rate nomogram: I.. Development. J. Urol.1979; 122: 665. Abstract, Google Scholar 7 : Intra- and inter-observer variations in classification of urinary flow curve patterns.. Neurourol. Urodynam.1990; 9: 535. Google Scholar 8 : The standardisation of terminology of lower urinary tract function. The International Continence Society Committee on Standardisation of Terminology.. Scand. J. Urol. Nephrol.1988; 114: 5. Google Scholar 9 Schouten, H. J. A.: Statistical Measurement of Interobserver Agreement. Ph.D. dissertation. Rotterdam, Erasmus University, 1985. Google Scholar 10 : Statistical Methods for Rates and Proportions. New York: John Wiley & Sons, Inc.1981. Google Scholar 11 : Applied Logistic Regression. New York: John Wiley & Sons, Inc.1989. Google Scholar 12 : Maximum and average urine flow rates in normal male and female populations-the Liverpool nomograms.. Brit. J. Urol.1989; 64: 30. Google Scholar 13 : Urodiagrams: a new method of uroflow pattern analysis.. J. Urol.1983; 130: 309. Abstract, Google Scholar 14 : Urinary flow curve patterns and their prognostic value in males over the age of 50 years.. Neurourol. Urodynam.1992; 11: 473. Google Scholar 15 : Bladder neck dyssynergia and prostatitis.. In: Prostatic Obstruction: Pathogenesis and Treatment. Edited by . London: Springer Verlag1995: 213. chapt. 13. Google Scholar 16 : Bladder outlet obstruction versus impaired detrusor contractility: the role of uroflow.. J. Urol.1991; 145: 810. Abstract, Google Scholar 17 : Why pressure-flow studies should be optional and not mandatory studies for evaluating men with benign prostatic hyperplasia.. Urology1994; 44: 156. Google Scholar 18 : In support of pressure-flow studies for evaluating men with lower urinary tract symptoms.. Urology1994; 44: 153. Google Scholar 19 : Criteria for differentiation of normal and abnormal uroflowmetrograms in adult men.. Brit. J. Urol.1994; 73: 494. Google Scholar 20 : Uroflowmetry in elderly men. World J. Urol.1995; 13: 21. Google Scholar Department of Urology, University Hospital Maastricht and Department of Health Policy and Management, Erasmus University, Rotterdam, Netherlands.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byVENHOLA M, REUNANEN M, TASKINEN S, LAHDES-VASAMA T and UHARI M (2018) Interobserver and Intra-Observer Agreement in Interpreting Urodynamic Measurements in ChildrenJournal of Urology, VOL. 169, NO. 6, (2344-2346), Online publication date: 1-Jun-2003. Volume 157Issue 1January 1997Page: 164-168 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information C. Van De Beek More articles by this author H.J. Stoevelaar More articles by this author J. McDonnell More articles by this author H.G.T. Nijs More articles by this author A.F. Casparie More articles by this author R.A. Janknegt More articles by this author Expand All Advertisement PDF downloadLoading ...