A new grading system for evaluation of uroflowmetry-EMG results (Gülhane Grading System)

Year 2021, Volume: 3 Issue: 3, 227 - 233, 14.07.2021

Burak Köprü , Giray Ergin , Turgay Ebiloğlu , Bahadır Topuz

https://doi.org/10.38053/acmj.946296

Abstract

Aim: It is recommended that dysfunctional voiding diagnosis should made by the repeated uroflowmetry simultaneously pelvic floor electromyography (UF-EMG) + post void residual measurements. However, there is no evaluation system for UF-EMG parameters regarding the clinical diagnosis, follow up and treatment of these patients. In our study, we aimed to create a new grading system for the diagnosis of dysfunctional voiding by using UF-EMG parameters.
Materia and Method: We have retrospectively obtained UF-EMG and lower urinary tract symptom score results that performed to the children whom applied to our clinic with the symptoms of dysfunctional voiding between 2010 and 2015. A total of 856 reports were included into this retrospective cohort analysis. The proper 610 UF-EMG tests were graded according to our grading system. The UF-EMG grading system is divided into 4 grades: Grade 0: No EMG activity and normal uroflowmetry, Gradenon-EMG: Disturbed flow pattern with no EMG activity, Grade 1: EMG activity with no disturbed flow pattern, Grade 2: EMG activity with minimally disturbed flow pattern, Grade 3: EMG activity with moderately disturbed flow pattern, Grade 4: EMG activity with extremely disturbed flow pattern.
Results: There was no statistically significant difference between the demographic data of patient and control groups (p>0.05). According to grading system, day and nighttime incontinence were statistically significant increases as the grades increases (respectively, p<0,001, p=0,023). According to grading system we created as the grades increased the UF-EMG parameters and the questions of lower urinary tract dysfunction symptom score which evaluated the voiding phase results were statistically significant (p<0.05).
Conclusion: Grading system will be helpful to interpreting the results of the UF-EMG, which considered to be relatively difficult and thus, the diagnosis of the patients can be easier to evaluate and respond to the treatment by urologist.

Keywords

Lower urinary tract dysfunction, Dysfunctional voiding, Uroflowmetry-EMG, Grading system

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