The fundamentals of uroflowmetry practice, based on International Continence Society good urodynamic practices recommendations

Abstract

Aims: To review the recommendations on uroflowmetry in the International Continence Society (ICS) Standardization documents in order to identify a systematic approach to the delivery and interpretation of free flow rate testing in clinical practice. Methods: Expectations of service and good practice in uroflowmetry described in the ICS standards on Urodynamic Practice, Urodynamic Equipment, and Terminology for Lower Urinary Tract Function were identified and summarized. Results: Urodynamic centers should provide a suitable uroflowmetry testing environment. Equipment should be calibrated and maintained according to manufacturer requirements. Patients should be well-informed in advance of the test. They should be advised to avoid: knocking the machine; allowing the stream to move; squeezing the urethra; and body movements. It is generally appropriate to get more than one flow trace for each patient. Voided volume should be representative for the patient, for example by comparing with values recorded on a Bladder Diary. Post void residual (PVR) should be measured soon after testing. After the test, the urodynamicist should review the trace and ensure maximum flow rate and end of micturition are correctly identified in case the equipment has inappropriately taken the values from a trace artefact. Conclusions: The summary provides a systematic approach to ensure a representative, high quality, non-invasive flow test is carried out for individual patients.