Determination of Uroflowmetry Nomograms in Healthy Indonesian Children Aged 5 to 15 Years Old in Hasan Sadikin Hospital, Bandung

Abstract

Background: Uroflowmetry is a simple, non-invasive, feasible examination. The standard reference for uroflowmetric nomogram today is still under debate. The normal value of uroflowmetry on children is highly varied in each country, there is has not been any reference to use for normal value of uroflowmetry on children in Indonesia. We aimed to establish uroflowmetry nomograms for healthy Indonesia children in Hasan Sadikin Hospital Bandung based on healthy children uroflowmetry examination between 5 to 15 years of age. Methods: A total of 302 uroflowmetry examination were performed on healthy Indonesian children with no history of a renal, urological, or neurological disorder between the ages 5 and 15 years old. The voided volume, the maximum and average urinary flow rates were analyzed using statistical software. Linear regression analysis was used to generate nomograms. Result: Uroflowmetric parameters increased with increasing age, with the effect being more pronounced in girls. There were 2 groups, with group 1 consisting of patients 5 to 10 years old and group 2 consisting of patients 11 to 15 years old. There were 76 boys and 76 girls in group 1 and 75 boys and 75 girls in group 2. In group 1 the maximum and average flow rates were 15.07 ± 6.66 (ml/sec) and 9.29 ± 3.61 (ml/sec) for boys, and 15.23 ± 6.15 (ml/sec) and 9.43 ± 3.29 (ml/sec) respectively, for girls. In group 2 these rates were 16.14 ± 5.06 (ml/sec) and 9.77 ± 3.74 (ml/sec) for boys and 19.38 ± 7.15 (ml/sec) and 11.21 ± 3.41 (ml/sec) respectively, for girls. When comparing uroflow parameters between boys and girls, significantly higher values were obtained in girls regarding Voided volume (p<0.001), Qmax (p<0.001) and Qavg (p<0.001). Conclusion: Nomograms are important tools to asses the lower urinary tract abnormalities and to evaluate response of either surgical or medical therapy in children. Uroflowmetry is a simple, cost effective and noninvasive. This study provides uroflow parameters for mean maximum flow rate for healthy Indonesian healthy children aged 5 to 15 years old (boys and girls) in Hasan Sadikin Hospital Bandung and will hopefully promote wider application of uroflowmetry testing in the pediatric population.