The Study Of Uroflowmetry In Children With Phimosis

OBJECTIVE: To investigate the role of uroflowmetry in Children with phimosis.METHODS: Hospitalized children with phimosis during November 2013 to March 2014 in Shanghai Children Hospital were targeted subjects. The recruited phimosis children were then divided into three groups according to the wrapper condition, clinical signs as well as past history, i.e. A group consisted of pathological phimosis, B group were children with ballooning of foreskin or skewed path when children peed, C group were phimosis children without the aforementioned conditions. The uroflowmetry were assessed before and after circumcision. The related uroflowmetry indies were Maximum flow rate(Qmax)、Average flow rate(Qave)、Voing volume(VV), Voing time(VT), Flow time(FT), Time to maximum flow(Tmax) and uroflowmetry curves. Children’s height, weight and age were also assessed. T-test, Analysis of variance as well as Chi-square test were used to compare differences across different group.RESULTS: The sample consisted of 152 phimosis children, the mean age was 7.17±2.74years(range: 3-14 years). The proportion of A 、B、C group is 21.1%、 27%、52% respectively. The mean of Qmax was 13.14±4.37ml/s, Qave was 7.11±2.41ml/s,VV was 118.13±70.16 ml. The bell-shaped curve, plateau curve as well as Staccato occupied 86.2%、3.9%、9.9% respectively in the total sample.The Qmax is lower in phimosis children than normal children. The Qmax in A group and B group were significantly lower than normal children in almost each age group. As for children in C group, the Qmax is similar to normal children when they aged 3-7y but lower than normal children when they were ≥8 years old. After control for age and VV, there are significant difference in Qmax、Qave among the three groups, especially Qmax and Qave in A and B groups were lower than those in C group( Qmax:A group vs B group:9.66±2.13 vs 12.31±4.27, p=0.027, A group vs C group:9.66±2.13 vs14.98±4.13, p<0.001,B group vs C group: 12.31±4.27vs14.98± 4.13, p=0.001;Qave:A group vs B group:5.38±1.29 vs 6.83±2.27, p=0.028, A group vs C group:5.38±1.29 vs 7.96±2.44, p<0.001, B group vs C group: 6.83±2.277 vs 7.96±2.44, p=0.006), however no significant differences were found for VV、VT、FT and uroflowmetry curves across groups. But when further analyzed the difference between A and C group, marginally significant difference in uroflowmetry curves was found among those two groups(Proportion of abnormal curve:A group vs C group:21.9% vs 8.9%,X2=3.50, p=0.061).77 phimosis children finished follow-up interview(two-three months after circumcision) till now. The Qmax and Qave after circumcision significantly increased compared to before circumcision. Stratified by group, significant changes in Qmax、Qave were found in A group and B group but not for C group. There were no significant changes in the VV、VT、FT、Tmax and uroflowmetry curves before and after circumcision.CONCLUSIONS: Uroflowmetry can be as the indicator for evaluating the urinary function of phimosis children before and after circumcision, it can be used for evaluate whether phimosis children have the indication of circumcision in routine clinical work.