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ORIGINAL ARTICLE
Year : 2019  |  Volume : 30  |  Issue : 2  |  Page : 74-78

Differentiating tower from bell curves in smooth continuous uroflowmetry curves of healthy adolescents


Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan

Correspondence Address:
Shang-Jen Chang
Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien; School of Medicine, Buddhist Tzu Chi University, Hualien
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/UROS.UROS_100_18

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Introduction: The definition of each uroflow pattern is vague, and therefore, interpreting uroflowmetry curves is associated with low inter-rater agreement. The aim of the study is to evaluate whether subjective or objective parameters could better differentiate tower from bell curves. Materials and Methods: Uroflow curves of community healthy adolescents with smooth continuous curves and minimal fluctuations within optimal bladder volume were independent reviewed by two experienced pediatric urodynamists and classified as bell or tower. The objective parameters generated from uroflow curves including Franco-Yang (F-Y) index (≧80) and angle at peak flow rate (A_Qmax ≧80°) were also used to differentiate tower from bell. The participants were asked to complete dysfunctional voiding symptom score (10 items, score 0–3). Results: A total of 287 adolescents with a mean age of 15.3 ± 1.7 years were enrolled and 150 curves were eligible for analysis. The inter-rater agreement was low (kappa = 0.27). Adolescents with uroflow curves classified as tower though F-Y index and A_Qmax were associated with higher urgency score than those with bell curves. However, adolescents with the tower curves defined by interpreters did not have higher urgency scores. Conclusions: Objective classification of tower curves with may be more reliable than subjective classification by the urodynamists. However, a significant proportion of participants with tower curves did not have urgency symptoms.


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